Dispose Of Data Designed And Implemented About The Health Care Insurance Settlement Of Claims System

As the progress of the society and Internet. It make both opportunity and challenge exist. All kinds of trades make the research. For living and progress.All kinds of trades make the research and development in application of Internet actively, and develop some application system of Internet successfully, the Insurance become necessary in part of life. Nearly more than 20 years , with the incoming of scale and increasing speed , more than other years before, but contrast with developed country, it has long distance.As the progress of the economy ,the Insurance had matured in the developed country. Health care is the important embranchment of the Insurance. Take on the huge incoming. In my country, the Insurance is not mature, the quality is not good, the transaction is not scientific, the settlement of claims is so slow. And in developed country does not have this matter. They build the professional organization to provide service between the Insurance company and hospital.This dissertation has introduced the Health Care Insurance Settlement of Claims System's data processing.This system had developed by Vestacare Cop. My company had completed part of function the system. Design and implement the module of the system claim data processing is my work.My system is based on the J2EE frame.Client is the B/S mode, developed in Java language. The database is the Oracle Database, the server is the JBoss server, it has security characteristic .The system transmites the EDI file.EDI is for short of the Electronic Data Interchange.It will be the trade, the production, the transportation,the Insurance, the finance and the CIQ's business file. The EDI file exchange datas in the standard format by the E-mail.It is a new business in computer. In the EDI transmission side , we use the PGP encrypt technology. PGP(Pretty Good Privacy)is the most popular encrypt software for the moment.It is a mail encrypt software that based on RSA public key .My dissertation narrates the whole work of the system's claim data processing.It narrates the claim's imfomation be pick-up , the claim's information be check-up, the EDI be trasmited and the PGP encrypt technology in particular.1. Pick-up InformationFirst,pick-up the information from the originality claim. Create a new text document. Save it in the specific directory.Then change the document's format under the standard of the content's definition.Create a new claim at last.2. Check-up InformationAll of the claims be queried.First, query the patients'information.If pass, then check-up the PPO information.If pass too, then save the claim to the specific directory wait for sending.3. EDI Created and SendedEvery company all have the specific directory be used to save the regular claims. The program monitors the directory in every minutes. If the directory have claims reach the upper limit. The program executes the operation of the EDI created.If the number of claims aren't the upper limit, then create the EDI at 0:00.At last encrypt the EDI and send it to the remote PPO server for reprice the value.The System used more new technology, for example ,AJAX, EJB and so on.