Auxiliary management information system and method for preventing refusal of hospital medical insurance expenses

Abstract

The invention provides a hospital medical insurance expense nonpayment prevention auxiliary management information system, which comprises a management server and a user end, wherein the management server comprises a nonpayment prevention patient database, and an expense nature setting module, a drug attribute setting module, a patient information recognition module, a drug usage day prompt module, a reimbursement category setting module, a medical insurance policy information prompt module, a self-paying protocol verification module and a printing module communicating with the nonpayment prevention patient database. The drug usage days of the patient can be counted, a doctor is prompted when the drug usage days exceed, indication judgment can be carried out on drugs prescribed by the doctor, the drug usage indication is prompted to the doctor, the doctor can thus inform the patient or a family member, happening of the expense nonpayment possibility can be prevented from the source, convenience is provided for the doctor, medical disputes can be avoided, management by the hospital is facilitated, and obvious economic benefits are brought to the hospital.

Description

technical field [0001] The invention belongs to the technical field of medical systems, and in particular relates to an auxiliary management information system and a method for preventing refusal of payment of hospital medical insurance expenses. Background technique [0002] The basic medical security system is an integral part of the social security system and an important part of the health service. It is closely related to the vital interests of the people. With the continuous reform and improvement of my country's social security system, medical insurance covers more and more people. On the one hand, the suppressed medical needs of the people have been further released, and on the other hand, hospitals have also developed rapidly, which makes the medical insurance management institutions and hospital medical insurance managers more and more responsible and pressured in the control of medical insurance expenses . The cost of medical insurance patients has always been one ...

AI Technical Summary

Problems solved by technology

[0003] The hospital is the executor of the medical insurance policy and system. The effect of the medical service provided by the hospital to the insured directly affects the success or failure of the medical insurance policy and system, and affects the trust of the people and the medical insurance policy. Therefore, the hospital is in the process of implementing the medical insurance policy. It plays a very important role, and the front-line clinicians, as the direct dominators of medical insurance expenses, bear the main responsibility for the management of medical insurance expenses. However, the phenomenon of patients refusing to pay medical insurance expenses occurs from time to time. The reasons are mainly divided into the following: Points: 1) Doctors are inaccurate about medical insurance policies, and have not fully grasped the policy differences between different types of insurance; 2) Doctors use drugs that exceed the scope of medical insurance; 3) The dosage exceeds the prescribed dosage; 4) Use self-pay or part of self-pay Failure to fulfill the obligation to inform the patient or family members of the drug or diagnosis and treatment items, and did not sign the informed consent

For this reason, the above-mentioned reasons are easy to cause the situation of drug fee refusal to take place, which will bring bad consequences to the hospital, and seriously limit the development of the hospital. The existing patent publication number is a kind of inpatient medical insurance patient management system disclosed by CN104008449A , the system can effectively manage the medical insurance information of inpatients, which provides convenience for the hospital to manage the information of medical insurance patients, but it still does not solve the problem of medical insurance refusal. Messages, whether the medication is an indication, whether the patient or family member has signed a self-payment agreement, etc. remind the doctor to prevent the patient from refusing to pay the medical expenses. The auxiliary management information system and method of preventing the refusal to pay the medical insurance fee of the hospital

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