Medical insurance management information system mainly contains two parts of the data processing function and management function.
First, the data processing function. Refers to the medical insurance management process of the original data collection and transmission, processing, storage and output, in order to provide application and query.
1. data collection function: is the collection of raw data, that is, the different time and different management levels on the scattered raw data centralized, and through the equipment will be the raw data into the computer. Data collection is the basis of the entire data processing, the quality of its work is the key to the correct function of HIMIS.
2. Data transfer function: is the data or information from one subsystem to another subsystem, as well as in the transmission between different management levels. The speed and accuracy of data transfer is an important function of the system.
3. Data storage function: is the original data and processing of a variety of information stored for future use. Here not only should pay attention to the storage of data or information medium, but also pay attention to the organization of its storage (such as logical relationships) and other issues, so as to effectively improve the efficiency and safety of HIMIS.
4. Data processing function: to enter the HIMIS in a variety of data classification, merging, summarization, statistical calculations, so as to produce useful information to meet the needs of different management levels. Data processing is the core function of HIMIS, the higher the processing level of the system, the more to meet the different management levels of information needs. Improvement of the level of computing technology, mathematical models and the development of computational methods, so that HIMIS greatly improves the data processing capabilities.
5. Output information function: HIMIS according to the user's different needs, in different forms to provide information to the user. Whether the output information is easy to read and understand, intuitive and eye-catching, will have a direct impact on the use of HIMIS effect and functionality of the expansion.
Second, management functions. Refers to the activities used to manage the business process of health insurance, manifested in the following aspects.
1. Control function: monitoring and checking the operation of each process, link and specific work in the management of medical insurance, comparing the deviation between planning and implementation, and controlling the management work according to the results of comparative analysis, in order to achieve the desired purpose.
2. Forecasting function: Based on the past data, using various mathematical methods and models, it predicts the future health of health insurance participants as well as the raising and payment of premiums.
3. Decision-making function: Provide different reports on different management levels of health insurance, use mathematical models and other methods to put forward various decision-making options to assist the management to make decisions, planning and management of health insurance management organization.