中国医疗保险
中國醫療保險
중국의료보험
CHINA HEALTH INSURANCE
2015年
7期
45-47
,共3页
信息化建设%医保智能辅助审核%实时在线监控
信息化建設%醫保智能輔助審覈%實時在線鑑控
신식화건설%의보지능보조심핵%실시재선감공
information construction%smart auxiliary auditing for the medical insurance%online real-time monitoring
成都市以信息化建设为抓手，全力推进智能辅助审核、实时在线监控、廉政风险防控、社会监督、个人权益维护等五大子系统，初步实现医疗保险管理由人工监管向智能监管，随机抽查向全面覆盖，事后审查向事前预防、事中监控、事后追责，自体监督向自体和异体监督相结合的转变，医疗保险治理能力得到明显提升。
成都市以信息化建設為抓手，全力推進智能輔助審覈、實時在線鑑控、廉政風險防控、社會鑑督、箇人權益維護等五大子繫統，初步實現醫療保險管理由人工鑑管嚮智能鑑管，隨機抽查嚮全麵覆蓋，事後審查嚮事前預防、事中鑑控、事後追責，自體鑑督嚮自體和異體鑑督相結閤的轉變，醫療保險治理能力得到明顯提升。
성도시이신식화건설위조수，전력추진지능보조심핵、실시재선감공、렴정풍험방공、사회감독、개인권익유호등오대자계통，초보실현의료보험관이유인공감관향지능감관，수궤추사향전면복개，사후심사향사전예방、사중감공、사후추책，자체감독향자체화이체감독상결합적전변，의료보험치리능력득도명현제승。
Taking information construction as a key point in Chengdu, five-subsystems, i.e., smart subsidiary auditing, real-time online monitoring, corruption risk preventing and controlling, social supervising, personal rights and interests maintaining, has been intensively promoted. It has preliminarily implemented following changes in medical insurance supervision, i.e., from manual supervision to intelligent supervision, from random supervision to universal supervision, from afterward auditing to pre-prevention, intermediate supervision, post-blaming, and from self supervision to combined self-supervision and other-person supervision. As a result, the health insurance management ability has been significantly improved.
