At present, the means of controlling fees are highly dependent on labor, the technology is relatively backward and single, and the audit is not comprehensive enough. However, with the development of big data technology, a tripartite supervision platform has emerged, such as Yilian Yikang. They conducted intelligent audit, supervision and decision-making on medical insurance funds through more advanced big data means, which greatly improved the discovery and solution of fraudulent insurance.
Contradictions to be solved:
1, the problem of isolated island of hospital data information, whether it can break through the information barrier, has become the key to control the medical insurance cost of big data.
2. Data information security; Recently, information leakage broke out in JD.COM. Some big data companies will desensitize data to ensure information security.
3. At present, the national medical insurance system is not connected to the internet, so fraudulent insurance incidents such as settlement in different places occur frequently. Yilian Yikang once explained that through multi-dimensional behavior analysis of policyholders through big data, some insurance fraud incidents can be found, but it is still a top priority to solve the problem of medical treatment in different places.
Impact: The most important thing is to reduce the loss of medical insurance funds, and truly realize taking it from the people and using it for the people. In addition, the auxiliary decision-making function of big data medical insurance control fees can also help medical insurance fund decision-makers to formulate scientific medical insurance policies.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.