社会保险综合服务管理平台补充医保管理软件设计及实现  

Design and implementation of supplementary medical insurance management software for social insurance comprehensive service management platform

作　　者：李世春 马美娟 刘冰 蒲伟 柳调红 LI Shichun;MA Meijuan;LIU Bing;PU Wei;LIU Tiaohong(Information Technology Institute of China Railway Lanzhou Bureau Group Co.,Ltd.,Lanzhou 730000,China)

机构地区：[1]中国铁路兰州局集团有限公司信息技术所,兰州730000

出　　处：《计算机应用文摘》2024年第14期65-67,共3页Chinese Journal of Computer Application

摘　　要：结合中国铁路兰州局集团有限公司(以下简称“集团公司”)企业补充医疗保险政策实施流程,文章基于社会保险综合服务管理平台设计了补充医保管理软件。该软件结合社会保险综合服务管理平台现有人员参保信息,实现了医疗数据的线上获取、文件导入、手工录入、自动初审、批量审核与单条审核;可根据政策自主调整公式参数以计算补助金额;能够按批次核定医疗补助发放金额,并推送银行发放明细及回执等。目前,该软件已应用于集团公司,在降低经办人员工作强度、降低医疗数据篡改风险、提高补助发放效率和智能化管理水平等方面发挥了积极作用,为集团公司企业补充医疗保险政策实施向数字化、自动化、智能化转型提供了重要技术支撑。Based on the implementation process of the enterprise supplementary medical insurance policy of China Railway Lanzhou Bureau Group Co.,Ltd.(hereinafter referred to as the“Group Company”),this article designs a supplementary medical insurance management software based on the social insurance comprehensive service management platform.This software combines the existing personnel insurance information of the social insurance comprehensive service management platform to achieve online acquisition,file import,manual input,automatic initial review,batch review,and single item review of medical data.Formula parameters can be adjusted independently according to policies to calculate subsidy amounts.Be able to verify the amount of medical subsidies disbursed in batches and push bank disbursement details and receipts.At present,the software has been applied in the group company,playing a positive role in reducing the workload of handling personnel,reducing the risk of medical data tampering,improving the efficiency of subsidy distribution,and enhancing the level of intelligent management.It provides important technical support for the group company to supplement the implementation of medical insurance policies and transform towards digitization,automation,and intelligence.

关 键 词：企业补充医疗保险 社保信息化 数据加密 政企直联 银企直联 

分 类 号：TP311[自动化与计算机技术—计算机软件与理论]