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 original 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 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 the information obtained from a variety of storage for future use. Here we should not only pay attention to the storage of data or information media, 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 security of HIMIS. 4. Data processing functions: 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 needs of different management levels of information. Improvement in the level of computing technology, mathematical models and the development of computing methods, so that HIMIS greatly improve the data processing capabilities. 5. Output information function: HIMIS according to the different needs of users, in different forms of information provided 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 and the expansion of the function.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, 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 past data, use various mathematical methods and models to predict the future health of health insurance participants and 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 a variety of decision-making options to assist management in making decisions, planning and management of health insurance management organization.