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预警监控 | early warning and monitoring |
降本增效 | reduce costs and increase efficiency |
门诊 | outpatient service |
门慢人群 | the group with chronic diseases covered by medical insurance |
门慢人群 | outpatient-specified NCD group |
违规汇总 | violation summary |
达标 | up-to-standard |
身份验证 | identity authentication |
身份核验 | identity verification |
费用转移 | expense transfer |
费用初审 | preliminary review of expenses |
费用分担 | cost sharing |
诚信管理 | integrity management |
营养摄入 | nutrition intake |
自费 | self-paying |
脑卒中 | cerebral stroke |
肺炎 | pneumonia |
网上审核 | online review |
绩效评价 | performance evaluation |
绩效考核体系 | performance appraisal system |
绩效工资 | performance-related pay |
统一身份认证 | unified identity authentication |
经办机构终审 | final review by responsible agency |
线下经办 | offline processing |
线上服务 | online service |
线上处方 | online prescription |
纳入医保范围内的 | included in medical insurance |
精准化、便捷化 | accuracy and convenience |
筛查 | identify |
稽核计划制定 | audit plan formulation |
稽核监控 | audit and monitoring |
稽核全流程管理 | whole-process audit management, |
社保卡鉴权 | social security card authentication |
病种 | disease types |
病患转移 | patient transfer |
病例审核 | medical record review |
疾病防控 | disease prevention and control |
电子社保卡 | electronic social security card |
电子病历 | electronic medical records |
生物特征识别技术 | biometric recognition technology |
生物特征识别技术 | biometric recognition technologies |
现场稽核 | on-site audit |
现场核查 | on-site verification |
流感疫苗接种 | influenza vaccination |
水电煤缴费 | utiity payment |
欺诈和浪费 | fraud and waste |
模型验证 | model validation |
模型调优 | model tuning |
模型分析 | model analysis |
标签画像 | label portraits |
智能审核子系统 | Intelligent Review Subsystem |
智慧就医 | intelligent medical treatment |
数据管理 | data management |
数据清洗 | data cleaning |
数据标准 | data standards |
数据挖掘 | data mining |
数据分析服务 | Data Analysis Service |
支付管理 | payment management |
支付标准制定 | payment standard setting |
控费 | expense control |
成本管理 | cost management |
慢病肾病 | chronic renal disease |
慢病 | NCD |
慢特病资格库 | qualified Special NCDs database |
慢特病 | Special NCDs |
循证医学 | evidence-based medicine |
建模 | modelling |
床日 | bed day |
并发症 | complication |
家庭医生签约 | family doctor contract |
家庭医生 | family doctors |
审核人员 | reviewers |
学科建设 | discipline development |
大病保险 | critical illness insurance |
多样性、高风险性、不易比较 | diversity, high risk and difficulty in comparison |
基层支付制度改革 | grassroot payment reform |
商保商城 | commercial insurance supermarket |
可评估性 | evaluability |
反馈确认 | feedback confirmation |
参保人 | the insured |
协议网签 | online agreements signing |
协议管理 | agreement management |
医院支付制度改革 | Hospital Payment Reform |
医疗资源投入 | medical resource investment |
医疗行为 | medical activities |
医疗网络 | medical network |
医疗保障经费 | medical security funds |
医疗不足风险管理 | medical insufficient risk management |
医师培训计划 | physician training plan |
医务人员 | hospital staff |
医保缴费 | medical insurance payment |
医保移动支付 | medical insurance mobile payment |
医保查询 | medical insurance inquiry |
医保支付范围 | coverage of medical insurance |
医保医师 | Medical Insurance Doctors |
医保 | medical insurance |
分级诊疗 | tiered diagnosis and treatment |
冠心病 | coronary heart disease |
免疫 | immunization |
健康画像 | healthy portrait |
健康档案 | health records |
信用卡还款 | credit card repayment |
信息维护 | information maintenance |
保本微利 | protecting the principal while gaining a small profit |
以“疾病治疗”为核心 | disease treatment-centered |
以“健康管理”为中心 | health management-centered |
付费测算 | payment calculation |
人工稽核服务 | Munual Audit Service |
亚健康人群 | people with sub-health conditions |
事后人工审核服务 | Ex Post Munual Review Service |
临床医学 | clinical medicine |
个账购买 | individual account purchase |
两定单位 | “two designated units” (designated medical institutions and pharmacies for medical insurance) |
专家复审 | expert review |
一体化风控服务 | Integrated Risk Control Service |
“最多跑一次” | “One Visit at Most” |
PBM | PBM (Pharmacy Benefit Management) |
DRGs分组算法 | DRG grouping algorithm |
DRGs | DRGs (Diagnosis Related Groups) |
BI | BI (Business Intelligence) |
省内外异地实时联网结算系统 | interprovincial real-time networking and settlement system |
医疗卫生制度 | healthcare system |
医疗健康 | health care |
异地就医直接结算 | Real-time site-off settlement |
基本药物 | essential medicine |
药品电子监管码 | drug electronic supervision code |
耗材 | consumable |
大病保险 | serious disease insurance |
病案 | medical records |
“最多跑一次” | 临床医学医疗器械专业术语
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