公开(公告)号：KR101439809B1

公开(公告)日：2014-09-12

申请号：KR1020140053565

申请日：2014-05-02

Applicant: 국민건강보험공단

Inventor： 정성화 ,  박경희

IPC: G06Q50/22 ,  G06Q40/08 ,  G06Q50/26

CPC classification number: G06Q50/22 ,  G06Q40/08 ,  G06Q50/26

Abstract: A health insurance web EDI system according to one embodiment of the present invention includes a web electronic data interchange (EDI) server for receiving application data including a site change history, the closure of a workplace, workplace subscriber eligibility reporting and application, workplace subscriber qualification notice and inquiry, workplace subscriber premium related reporting and application, workplace subscriber premium related notification and inquiry, workplace subscriber premium refund reporting, medical record requests, advance salary restriction status inquiry, premiums payment subscriber premises probation and revocation notice, premium payment confirmation issue, workplace subscriber premium calculation history and personal expense reimbursement account application, and premiums paid/unpaid history inquiry; a web EDI DB server for storing the application data request to the web EDI server by an operator server; a four insurance relay server for extracting information required for four insurances from the data stored in the web EDI DB server for the transmission to servers for the transmission to four insurance servers; a eligibility management system for managing the health insurance eligibility of a workplace subscriber and for depriving, maintaining, and updating the health insurance eligibility of the workplace subscriber; a follow-up premium and payment managing system for performing processes based on the premiums payment subscriber premises probation and revocation notices, premium payment confirmation issue, workplace subscriber premium calculation history and personal expense reimbursement account application, and premiums paid/unpaid history; a health screening management system for performing processes related to the history of the health examination recipient; and a four insurance linkage server for storing, maintaining, depriving, and updating four insurance-related data of the workplace subscriber.

Abstract translation: 根据本发明的一个实施例的健康保险网络EDI系统包括网络电子数据交换（EDI）服务器，用于接收包括站点改变历史，工作场所关闭，工作场所用户资格报告和应用的应用数据，工作场所用户资格 通知和查询，工作场所用户保险费相关报告和申请，工作场所用户保险费相关通知和查询，工作场所用户保费退款报告，医疗记录请求，预支薪酬限制状态查询，保费支付用户住宅试用和撤销通知，保费支付确认问题， 工作场所用户费用计算历史和个人费用报销账户申请，付费保费/无偿历史查询; 网络EDI DB服务器，用于由操作员服务器将应用数据请求存储到网络EDI服务器; 四个保险中继服务器，用于从存储在网络EDI DB服务器中的数据中提取四个保险所需的信息，以传输到服务器以传输到四个保险服务器; 管理工作场所用户健康保险资格和剥夺，维护和更新工作场所用户健康保险资格的资格管理系统; 根据保费支付用户房屋试用期和撤销通知，保费支付确认书，工作场所用户费用计算历史和个人费用报销账户申请以及付费保险费/未付费历史进行后续保费和支付管理系统; 健康检查管理系统，用于执行与健康检查接受者的历史相关的过程; 以及用于存储，维护，剥夺和更新工作场所用户的四个保险相关数据的四个保险联动服务器。