句容市实现医保综合业务“一站式”受理


Recently, Jurong City Medical Insurance Center added a special window, in this window, no longer through the manual participants of the cost list classification, but through the window of the "electronic eye" to record the identification of the cost list, and then through this "eye" feedback to the directory library intelligent identification system "brain" for automatic classification, according to the list of unit prices and amounts for accurate settlement.

According to Jurong City Medical Insurance Center Director Peng Zhong, "electronic eyes" from the city's medical insurance department has been focused on promoting the comprehensive medical insurance teller system. After nearly a year of standard database construction and module classification settings as well as six months of business testing and reimbursement data measurement, Jurong City's comprehensive medical insurance teller system has now entered the trial operation stage, realizing the comprehensive medical insurance business "one-stop" processing. At the integrated business window, reimbursement lists, invoices, transfer certificates, social security cards and other materials are scanned through the "electronic eye" and OCR text recognition software into the computer database settlement system, and the entries of the expense lists are automatically matched with the catalogue library, and the reimbursement results are automatically calculated through the system. The platform not only improves efficiency, but also reduces manual review errors.

After the comprehensive medical insurance teller system is fully online, the Jurong City Medical Insurance Department will set up the details of the reimbursement expenses on the human society WeChat platform or APP platform. The claimant will then be able to see not only the total cost of the claim, but also the cost and reimbursement rate of each test, drug and material at any time from their own mobile phone. This service will effectively improve the transparency of the audit, allowing participants to see their doctors clearly and know their account information instantly.

In the future, the medical insurance department of Jurong City will also use the information system of the integrated teller system to realize big data management and implement refined data measurement and analysis of reimbursement types, reimbursement items and various types of expenses, so as to provide a practical basis for the evaluation of the security of medical insurance funds and the targeted adjustment of medical insurance policies.

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