![药品报销信息异常的方法和装置](/CN/2018/1/252/images/201811264702.jpg)
基本信息:
- 专利标题: 药品报销信息异常的方法和装置
- 专利标题(英):Method and device for abnormal drug reimbursement information
- 申请号:CN201811264702.5 申请日:2018-10-27
- 公开(公告)号:CN109523398A 公开(公告)日:2019-03-26
- 发明人: 张淦
- 申请人: 平安医疗健康管理股份有限公司
- 申请人地址: 上海市黄浦区北京东路666号H区(东座)12G室
- 专利权人: 平安医疗健康管理股份有限公司
- 当前专利权人: 平安医疗健康管理股份有限公司
- 当前专利权人地址: 上海市黄浦区北京东路666号H区(东座)12G室
- 代理机构: 广州三环专利商标代理有限公司
- 代理人: 郝传鑫; 熊永强
- 主分类号: G06Q40/08
- IPC分类号: G06Q40/08 ; G16H20/10
A Method and device for abnormal drug reimbursement information are provided, wherein the method comprises: obtaining a drug insurance settlement request for a target drug, The drug insurance premiumsettlement request includes the identity information of the user in the preset state, the reimbursement information corresponding to the target drug, and the weight information and height informationof the user in the preset state. Determining The insured amount and the accumulated reimbursement amount of the user in the preset state in the reimbursement period of the target drug according to theidentity information and the reimbursement information. Determining The single dose according to the weight information, height information and dosage rules. According to the insured amount and the drug benefit rule, determining the reimbursement threshold and the reimbursement time limit corresponding to the target drug, wherein the reimbursement threshold is greater than or equal to the insuredamount; If the insurance premium settlement request meets the reimbursement time limit and the cumulative reimbursement premium is greater than the reimbursement threshold, determining that the drugpremium settlement request is abnormal, and sending an abnormal reimbursement prompt. The technical proposal of the invention can reduce the fraudulent insurance behavior.
公开/授权文献:
- CN109523398B 药品报销信息异常的方法和装置 公开/授权日:2024-05-14