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Application Research of Refined Management System based on Big Data and Intelligent Supervision in the field of Medical Insurance

Published: 13 January 2025 Publication History

Abstract

This study explores the establishment of a refined management system for medical insurance in hospitals and its impact on hospital administration. By designing a systematic structural framework and a rule base, functional modules that closely resemble the hospital's actual business scenarios have been constructed, thereby extending medical insurance supervision from post-event to in-process and pre-event monitoring. Based on medical insurance management practices, the study analyzes the functions of the refined medical insurance management system and its application effectiveness in medical insurance administration. Comparative experimental data indicate that after the system's implementation, violations of medical insurance regulations have significantly decreased, the efficiency of medical insurance management has improved, the quality of hospital management has been enhanced, and hospital operating costs have been reduced. The application of the refined management system for medical insurance in hospitals contributes to upgrading the hospital's governance capabilities and medical insurance management level, ensuring the safety and rational use of medical insurance funds.

References

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Okuzu O, Malaga R, Okereafor K, et al. Role of digital health insurance management systems in scaling health insurance coverage in low-and Middle-Income Countries: A case study from Nigeria[J]. Frontiers in Digital Health, 2022, 4: 1008458.
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  1. Application Research of Refined Management System based on Big Data and Intelligent Supervision in the field of Medical Insurance

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    ISAIMS '24: Proceedings of the 2024 5th International Symposium on Artificial Intelligence for Medicine Science
    August 2024
    967 pages
    ISBN:9798400717826
    DOI:10.1145/3706890
    Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than the author(s) must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected].

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    Association for Computing Machinery

    New York, NY, United States

    Publication History

    Published: 13 January 2025

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    Author Tags

    1. Big data technology
    2. Intelligent supervision
    3. Medical insurance
    4. Monitoring rules
    5. Refined management system

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    Overall Acceptance Rate 53 of 112 submissions, 47%

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