3.1 Development Platform
Provincial civil administration of the "one-stop" compensation management system for the medical insurance of the preferential objects construction, development using the . NET is the Microsoft XML WebServices platform, XML WebServices allow applications to communicate and *** enjoy data over the Internet, regardless of the operating system, device or programming language used. Microsoft/NET platform provides the creation of XML WebServices and these services and will be used to provide the services. The Microsoft/NET platform provides what you need to create XML WebServices and integrate these services together.
With the .NET Enterprise Server family, IT professionals can leverage the same technologies used to build the . NET platform will fundamentally change the way companies interact with their customers and partners on the Internet.
3.2 database technology
Provincial civil society to protect the object of medical insurance "one-stop" compensation management system construction using a large-scale database system SQL Server 2005, this system should support but not limited to the following: the use of background mechanisms to complete the storage of data logic, processing, Aggregation, etc.; the system must be able to ensure data integrity, such as primary key integrity and referential integrity definitions, in the data to support the third paradigm (3NF); can have a better locking mechanism and the ability to resolve conflicts; the ability to optimize the storage can be inserted into a massive amount of data within a short period of time, update, delete specific data;
According to the current understanding and analysis of the overall business needs, this management system can be divided into "one-stop" compensation system, "one-stop" compensation system, "one-stop" compensation system, "one-stop" compensation system. Based on our current understanding and analysis of the overall business requirements, the management system can be divided into "one-stop" instant settlement service system into civil affairs, hospitals, finance, health insurance and NAC end.
1, the civil affairs end of the main functions:
(1) basic information: administrative division information settings, medical service unit settings, the object file information, the object medical card management, the object account of the initial object, the object account management, the object of the balance of the medical fee query.
(2) report query: outpatient reimbursement schedule, hospitalization reimbursement schedule, the object of the statistical table, the object of the reimbursement statistics, the object of the reimbursement statistics, medical institutions reimbursement statistics, the classification of medical institutions statistics, administrative division reimbursement statistics, administrative division classification statistics, the object of the classification of the reimbursement of statistics, the object of the reimbursement of the chart of the analysis of the object of the reimbursement of the advantages.
2. The main functions of the hospital side: outpatient reimbursement for the beneficiaries, inpatient reimbursement for the beneficiaries, basic information, report query and so on.
(1) Basic information: remote login settings, classified information on the beneficiaries, and files on the beneficiaries.
(2) outpatient reimbursement: the new rural cooperative reimbursement in accordance with the prescribed ratio, the fixed outpatient subsidies for those in favor of the object.
(3) hospitalization reimbursement: preferential reductions and exemptions for medical institutions, reimbursement for participation in the insurance (co-insurance), assistance for major illnesses, and medical subsidies for those who have been given preferential treatment.
(4) report inquiry: outpatient reimbursement schedule, hospitalization reimbursement schedule, outpatient reimbursement summary table, hospitalization reimbursement summary table, reimbursement summary table for the privileged object, reimbursement reconciliation table for the privileged object.
3, the financial end of the main functions:
According to the civil affairs provided by the funds disbursement program, regularly disbursed to the medical institutions of medical assistance funds.
4. The main functions of the medical insurance and NAC end:
Instant reimbursement at medical institutions for in-county visits; out-of-county visits where individuals advance the relevant expenses first and then reimbursement is made at the medical insurance or NAC office.
Note: The software is now used in Anhui Province (the province), Wenzhou City, Zhejiang Province, Haidong District, Qinghai Province, Guangdong Province (the province's 12 municipalities), Baoding City, Hebei Province, Daqing City, Heilongjiang Province, Liaoning Province, Sichuan Province, Yunnan Province and other more than a dozen provinces and districts in more than 400 cities and counties units. Has now become the industry's first choice, the first brand!