TWM614808U - System of obtaining claim data from integrated platform and depositing it on blockchain - Google Patents
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Abstract
一種由整合平台取得理賠資料並由區塊鏈存證之系統,其透過客戶端產生包含病患之身分識別資料的理賠申請資料後,平台主機依據身分識別資料向醫療主機請求病患資料並將病患資料提供給保險伺服器以進行理賠,並將包含理賠申請資料及病患資料之病患理賠資料加密後發布到區塊鏈之技術手段,可以減少被保險人向保險公司申請理賠的時間,並達成在保險公司與醫療機構間提供安全與方便之資料傳遞機制的技術功效。A system that obtains claim data from an integrated platform and deposits it on the blockchain. After the client generates claim data containing patient identification data, the platform host requests the patient data from the medical host based on the identification data and sends The patient data is provided to the insurance server for claim settlement, and the patient claim data including the claim application data and patient data are encrypted and published to the blockchain technology, which can reduce the time for the insured to apply for the claim to the insurance company , And achieve the technical effect of providing a safe and convenient data transmission mechanism between insurance companies and medical institutions.
Description
一種線上理賠系統,特別係指一種透過整合平台與區塊鏈取得資料進行理賠之系統。An online claims system, in particular, a system that obtains data through an integrated platform and blockchain for claims settlement.
過去被保險人在向保險公司請求理賠時,需要向醫療機構申請診斷證明書,並等待診斷證明書開立,在取得診斷證明書後,被保險人還需要到保險公司遞交包含診斷證明書與病歷調查同意書等資料的理賠申請文件以申請理賠。保險公司在收到理賠申請文件後,會審查理賠申請文件的真偽,並向醫療機構調查被保險人的病歷,並依據調查取得之被保險人的病歷進行理賠作業。In the past, when the insured requested a claim from the insurance company, he had to apply for a diagnosis certificate from the medical institution and wait for the diagnosis certificate to be issued. The medical record survey consent form and other materials to apply for claims. After the insurance company receives the claims application documents, it will review the authenticity of the claims application documents, investigate the medical records of the insureds with medical institutions, and perform claims settlement operations based on the medical records of the insureds obtained through the investigation.
雖然現在保險公司也提供了線上申請理賠的機制,但仍然需要由被保險人在線上填寫理賠申請資料並上傳診斷證明書與病歷調查同意書等資料,如此,被保險人還是需要花費額外的時間到機療機構申請並等待診斷證明書開立,同時,若被保險人要向多家保險公司申請理賠,也需要逐一到各保險公司的伺服器填寫理賠申請資料,此外,各保險公司也需要與各家醫療機構簽約連接以傳遞病歷資料,否則仍然需要親自到醫療機構調查病歷。Although insurance companies now also provide a mechanism for online claim settlement, it is still necessary for the insured to fill in the claim application materials online and upload the diagnosis certificate and medical record survey consent form. In this way, the insured still needs to spend extra time Apply to the medical institution and wait for the diagnosis certificate to be issued. At the same time, if the insured wants to apply for claims from multiple insurance companies, he also needs to go to the server of each insurance company to fill in the claim application materials. In addition, each insurance company also needs Sign contracts with various medical institutions to transmit medical records, otherwise you still need to go to the medical institutions to investigate the medical records in person.
另外,目前也有透過區塊鏈共享病歷的相關技術。例如,中華民國第I683275/M569002號專利案揭露讀取端資訊裝置可以將病歷資訊寫入區塊鏈中,並傳送到病歷中心伺服器儲存,當讀取端資訊裝置需要讀取病歷資訊時,可以使用病歷中心伺服器所提供的金鑰進行身分驗證。然而,由於讀取端資訊裝置寫入區塊鏈中的病歷資訊為明文,因此可以存取區塊鏈的任何人都可以取得病歷資料,病患無法保有隱私;又如,中華民國第202001926號專利申請案揭露醫院端系統將病歷加密後寫入區塊鏈中,病患可以使用醫院端系統所發給的金鑰解密區塊鏈上所記錄的病歷,雖然此申請案可以只讓病患查看自己的病歷保有自身的隱私,但無法與其他單位共享,保險公司並無法由區塊鏈中取得病患的病歷,仍然需要到醫療機構才能取得病患的病歷。In addition, there are also related technologies for sharing medical records through blockchain. For example, the Republic of China Patent No. I683275/M569002 discloses that the reader-side information device can write medical record information into the blockchain and send it to the medical record center server for storage. When the reader-side information device needs to read the medical record information, You can use the key provided by the medical record center server for identity verification. However, since the medical record information written in the blockchain by the reader-side information device is in plaintext, anyone who can access the blockchain can obtain the medical record data, and patients cannot maintain privacy; another example is the Republic of China No. 202001926 The patent application reveals that the hospital system encrypts the medical records and writes them to the blockchain. Patients can use the key issued by the hospital system to decrypt the medical records recorded on the blockchain, although this application can only allow patients Checking your own medical records maintains your own privacy, but it cannot be shared with other units. Insurance companies cannot obtain the patient's medical record from the blockchain. You still need to go to the medical institution to obtain the patient's medical record.
綜上所述,可知先前技術中長期以來一直存在被保險人需要花費額外時間向各家保險公司申請理賠且各保險公司需要花費成本與各醫療機構簽約連線才能在保有病患隱私的情況下取得病患病歷的問題,因此有必要提出改進的技術手段,來解決此一問題。In summary, it can be seen that in the prior art, there has been a long-standing existence in the prior art that the insured needs to spend extra time to apply for claims from various insurance companies, and each insurance company needs to spend the cost to sign and connect with various medical institutions in order to maintain patient privacy. The problem of obtaining patient medical records, so it is necessary to propose improved technical means to solve this problem.
有鑒於先前技術存在被保險人需要花費額外時間向各家保險公司申請理賠且各保險公司需要花費成本與各醫療機構簽約連線的問題,本創作遂揭露一種由整合平台取得理賠資料並由區塊鏈存證之系統,其中:In view of the prior art that the insured needs to spend extra time to apply for claims to various insurance companies, and each insurance company has to spend cost to sign and connect with various medical institutions, this creation reveals a method of obtaining claims information from an integrated platform and from the district. Blockchain deposit certificate system, including:
本創作所揭露之由整合平台取得理賠資料並由區塊鏈存證之系統,至少包含:醫療主機,用以取得同意資料;客戶端,用以產生包含身分識別資料之理賠申請資料;保險伺服器,用以取得理賠申請資料;平台主機,用以取得理賠申請資料,並依據身分識別資料向醫療主機請求病患資料,使醫療主機產生病患資料,及平台主機用以傳送病患資料至保險伺服器,使保險伺服器依據病患資料執行理賠作業,及平台主機用以產生包含理賠申請資料及病患資料之病患理賠資料,並將病患理賠資料發布至聯盟區塊鏈中,及對病患理賠資料進行運算以產生運算值,並將運算值發布至公開區塊鏈中。The system disclosed in this creation that obtains claim data from an integrated platform and is certified by the blockchain includes at least: a medical host to obtain consent data; a client to generate claim application data containing identification data; insurance server The platform host is used to obtain the claim application data; the platform host is used to obtain the claim application information, and request patient information from the medical host based on the identification data, so that the medical host generates patient data, and the platform host is used to send the patient data to The insurance server enables the insurance server to perform claim settlement operations based on patient data, and the platform host is used to generate patient claim data including claim application data and patient data, and publish the patient claim data to the alliance blockchain. And calculate the patient's claim data to generate the calculated value, and publish the calculated value to the public blockchain.
本創作所揭露之系統如上,與先前技術之間的差異在於本創作透過客戶端產生包含病患之身分識別資料的理賠申請資料後,平台主機依據身分識別資料向醫療主機請求病患資料並將病患資料提供給保險伺服器以進行理賠,並將包含理賠申請資料及病患資料之病患理賠資料加密後發布到區塊鏈,藉以解決先前技術所存在的問題,並可以達成讓被保險人以更少的時間完成理賠申請及在保險公司與多個醫療機構及醫療機構與多個保險公司間提供安全與方便之資料傳遞機制的技術功效。The system disclosed in this creation is as above. The difference with the previous technology is that after this creation generates claims application data containing patient identification data through the client, the platform host requests the patient information from the medical host based on the identification data and then The patient data is provided to the insurance server for claim settlement, and the patient claim data including the claim application data and patient data are encrypted and published to the blockchain, so as to solve the problems of the previous technology and achieve the insured It takes less time for people to complete claims application and provides a safe and convenient data transfer mechanism between insurance companies and multiple medical institutions and medical institutions and multiple insurance companies.
以下將配合圖式及實施例來詳細說明本創作之特徵與實施方式,內容足以使任何熟習相關技藝者能夠輕易地充分理解本創作解決技術問題所應用的技術手段並據以實施,藉此實現本創作可達成的功效。The following will describe the features and implementation methods of this creation in detail with the drawings and embodiments. The content is sufficient to enable any person familiar with relevant skills to easily and fully understand the technical means used in this creation to solve technical problems and implement them accordingly. The achievable effect of this creation.
本創作可以操作客戶端產生理賠申請資料,使得公正第三方的平台主機向醫療主機取得病患的病患資料,使得保險公司所提供的保險伺服器依據所取得的病患資料進行理賠作業,同時由平台主機將理賠申請資料與病患資料加密後發布到區塊鏈中進行存證。其中,本創作所提之客戶端、保險伺服器、平台主機、醫療主機都可以是計算設備。This creation can operate the client to generate claims application data, so that a fair third-party platform host can obtain patient data from the medical host, and the insurance server provided by the insurance company can perform claim settlement operations based on the obtained patient data. The platform host encrypts the claims application data and patient data and publishes them to the blockchain for storage. Among them, the client, insurance server, platform host, and medical host mentioned in this creation can all be computing devices.
本創作所提之計算設備包含但不限於一個或多個處理模組、一條或多條記憶體模組、以及連接不同硬體元件(包括記憶體模組和處理模組)的匯流排等硬體元件。透過所包含之多個硬體元件,計算設備可以載入並執行作業系統,使作業系統在計算設備上運行,也可以執行軟體或程式。另外,計算設備也包含一個外殼,上述之各個硬體元件設置於外殼內。The computing devices mentioned in this creation include but are not limited to one or more processing modules, one or more memory modules, and hardware such as buses connecting different hardware components (including memory modules and processing modules). Body components. Through the included multiple hardware components, the computing device can load and execute the operating system, make the operating system run on the computing device, and can also execute software or programs. In addition, the computing device also includes a housing, and each of the above-mentioned hardware components is arranged in the housing.
本創作所提之計算設備的匯流排可以包含一種或多個類型,例如包含資料匯流排(data bus)、位址匯流排(address bus)、控制匯流排(control bus)、擴充功能匯流排(expansion bus)、及/或局域匯流排(local bus)等類型的匯流排。計算設備的匯流排包括但不限於的工業標準架構(Industry Standard Architecture, ISA)匯流排、周邊元件互連(Peripheral Component Interconnect, PCI)匯流排、視頻電子標準協會(Video Electronics Standards Association, VESA)局域匯流排、以及串列的通用序列匯流排(Universal Serial Bus, USB)、快速周邊元件互連(PCI Express, PCI-E/PCIe)匯流排等。The bus of the computing device mentioned in this creation can include one or more types, such as data bus, address bus, control bus, and extended function bus ( expansion bus), and/or local bus (local bus). The bus bars of computing devices include but are not limited to Industry Standard Architecture (ISA) bus, Peripheral Component Interconnect (PCI) bus, Video Electronics Standards Association (VESA) Bureau Domain bus, serial universal serial bus (Universal Serial Bus, USB), fast peripheral component interconnection (PCI Express, PCI-E/PCIe) bus, etc.
本創作所提之計算設備的處理模組與匯流排耦接。處理模組包含暫存器(Register)組或暫存器空間,暫存器組或暫存器空間可以完全的被設置在處理模組之處理晶片上,或全部或部分被設置在處理晶片外並經由專用電氣連接及/或經由匯流排耦接至處理晶片。處理模組可為中央處理器、微處理器或任何合適的處理元件。若計算設備為多處理器設備,也就是計算設備包含多個處理模組,則計算設備所包含的處理模組都相同或類似,且透過匯流排耦接與通訊。處理模組可以解釋一個計算機指令或一連串的多個計算機指令以進行特定的運算或操作,例如,數學運算、邏輯運算、資料比對、複製/移動資料等,藉以驅動計算設備中的其他硬體元件或運行作業系統或執行各種程式及/或模組。The processing module of the computing device mentioned in this creation is coupled with the bus. The processing module includes a register group or register space. The register group or register space can be completely set on the processing chip of the processing module, or all or part of it can be set outside the processing chip It is coupled to the processing chip via a dedicated electrical connection and/or via a bus. The processing module can be a central processing unit, a microprocessor or any suitable processing element. If the computing device is a multi-processor device, that is, the computing device includes multiple processing modules, the processing modules included in the computing device are all the same or similar, and they are coupled and communicated through a bus. The processing module can interpret a computer instruction or a series of multiple computer instructions to perform specific operations or operations, such as mathematical operations, logical operations, data comparison, copy/move data, etc., to drive other hardware in the computing device Components or run operating systems or execute various programs and/or modules.
計算設備中通常也包含一個或多個晶片組(Chipset)。計算設備的處理模組可以與晶片組耦接或透過匯流排與晶片組電性連接。晶片組是由一個或多個積體電路(Integrated Circuit, IC)組成,包含記憶體控制器以及周邊輸出入(I/O)控制器等,也就是說,記憶體控制器以及周邊輸出入控制器可以包含在一個積體電路內,也可以使用兩個或更多的積體電路實現。晶片組通常提供了輸出入和記憶體管理功能、以及提供多個通用及/或專用暫存器、計時器等,其中,上述之通用及/或專用暫存器與計時器可以讓耦接或電性連接至晶片組的一個或多個處理模組存取或使用。Computing equipment usually also contains one or more chipsets. The processing module of the computing device can be coupled to the chipset or electrically connected to the chipset through a bus. The chipset is composed of one or more integrated circuits (Integrated Circuit, IC), including memory controller and peripheral input/output (I/O) controller, that is, memory controller and peripheral input/output control The device can be included in one integrated circuit, or it can be implemented using two or more integrated circuits. Chipsets usually provide I/O and memory management functions, as well as multiple general-purpose and/or special-purpose registers, timers, etc., among which the aforementioned general-purpose and/or special-purpose registers and timers can be coupled or One or more processing modules electrically connected to the chipset are accessed or used.
計算設備的處理模組也可以透過記憶體控制器存取安裝於計算設備上的記憶體模組和大容量儲存區中的資料。上述之記憶體模組包含任何類型的揮發性記憶體(volatile memory)及/或非揮發性(non-volatile memory, NVRAM)記憶體,例如靜態隨機存取記憶體(Static Random Access Memory, SRAM)、動態隨機存取記憶體(Dynamic Random Access Memory, DRAM)、唯讀記憶體(Read-Only Memory, ROM)、快閃記憶體(Flash memory)等。上述之大容量儲存區可以包含任何類型的儲存裝置或儲存媒體,例如,硬碟機、光碟(optical disc)、隨身碟(flash drive)、記憶卡(memory card)、固態硬碟(Solid State Disk, SSD)、或任何其他儲存裝置等。也就是說,記憶體控制器可以存取靜態隨機存取記憶體、動態隨機存取記憶體、快閃記憶體、硬碟機、固態硬碟中的資料。The processing module of the computing device can also access the data in the memory module and the mass storage area installed on the computing device through the memory controller. The above-mentioned memory modules include any type of volatile memory (volatile memory) and/or non-volatile memory (NVRAM), such as Static Random Access Memory (SRAM) , Dynamic Random Access Memory (DRAM), Read-Only Memory (ROM), Flash memory, etc. The aforementioned mass storage area can include any type of storage device or storage medium, such as hard disk drives, optical discs, flash drives, memory cards, and solid state disks. , SSD), or any other storage device, etc. In other words, the memory controller can access data in static random access memory, dynamic random access memory, flash memory, hard disk drives, and solid state drives.
計算設備的處理模組也可以透過周邊輸出入控制器經由周邊輸出入匯流排與周邊輸出裝置、周邊輸入裝置、通訊介面、及GPS接收器等周邊裝置或介面連接並通訊。周邊輸入裝置可以是任何類型的輸入裝置,例如鍵盤、滑鼠、軌跡球、觸控板、搖桿等,周邊輸出裝置可以是任何類型的輸出裝置,例如顯示器、印表機等,周邊輸入裝置與周邊輸出裝置也可以是同一裝置,例如觸控螢幕等。通訊介面可以包含無線通訊介面及/或有線通訊介面,無線通訊介面可以包含支援無線區域網路(如Wi-Fi、Zigbee等)、藍牙、紅外線、近場通訊(Near-field communication, NFC)、3G/4G/5G等行動通訊網路(蜂巢式網路)或其他無線資料傳輸協定的介面,有線通訊介面可為乙太網路裝置、DSL數據機、纜線(Cable)數據機、非同步傳輸模式(Asynchronous Transfer Mode, ATM)裝置、或光纖通訊介面及/或元件等。處理模組可以週期性地輪詢(polling)各種周邊裝置與介面,使得計算設備能夠透過各種周邊裝置與介面進行資料的輸入與輸出,也能夠與具有上面描述之硬體元件的另一個計算設備進行通訊。The processing module of the computing device can also connect and communicate with peripheral output devices, peripheral input devices, communication interfaces, and GPS receivers and other peripheral devices or interfaces through the peripheral I/O controller through the peripheral I/O bus. The peripheral input device can be any type of input device, such as a keyboard, mouse, trackball, touchpad, joystick, etc. The peripheral output device can be any type of output device, such as a display, a printer, etc., a peripheral input device It can also be the same device as the peripheral output device, such as a touch screen. The communication interface can include a wireless communication interface and/or a wired communication interface. The wireless communication interface can include support for wireless local area networks (such as Wi-Fi, Zigbee, etc.), Bluetooth, infrared, near-field communication (NFC), 3G/4G/5G and other mobile communication network (cellular network) or other wireless data transmission protocol interface, wired communication interface can be Ethernet device, DSL modem, cable modem, asynchronous transmission Mode (Asynchronous Transfer Mode, ATM) devices, or optical fiber communication interfaces and/or components, etc. The processing module can periodically poll various peripheral devices and interfaces, so that the computing device can input and output data through various peripheral devices and interfaces, and can also interact with another computing device with the hardware components described above. To communicate.
以下先以「第1圖」本創作所提之由整合平台取得理賠資料並由區塊鏈存證之系統架構圖來說明本創作。如「第1圖」所示,本創作之系統含有醫療主機120、客戶端110、平台主機130、保險伺服器151。其中,醫療主機120與客戶端110、醫療主機與平台主機130、客戶端110與保險伺服器151可以透過有線網路或無線網路連接,藉以相互傳送資料或訊號;平台主機130與保險伺服器151可以串接相同的聯盟區塊鏈141。上述之有線網路包含但不限於乙太網路或光纖網路等;上述之無線網路例如行動通訊網路、無線區域網路、藍牙、紅外線、近場通訊等,但本創作並不以此為限。The following first illustrates this creation with the system architecture diagram of claim data obtained by the integrated platform and certified by the blockchain mentioned in the creation of "Picture 1". As shown in "Figure 1", the authored system includes a
客戶端110可以是電腦、手機等計算設備,但本創作並不以此為限。The
客戶端110負責取得病患的身分識別資料。一般而言,客戶端110可以提供使用者輸入病患的身分識別資料,但本創作並不以此為限,例如,客戶端110也可以載入預先記錄的身分識別資料。其中,本創作所提之病患的身分識別資料為足以識別出病患的資料,包含但不限於病患的身分證號、護照號碼、工作證號等。The
客戶端110也負責產生包含所取得之身分識別資料的理賠申請資料,並將所產生之理賠申請資料傳送給保險伺服器151或平台主機130。理賠申請資料除了包含身分識別資料之外,也可以包含申請理賠的表格或文件等資料。在部分的實施例中,理賠申請資料還可以包含申請理賠之保險公司的公司識別資料,病患看診之醫療機構的機構識別資料,及/或病患或病患家屬的通訊資料。其中,客戶端110可以將所取得之身分識別資料傳送給平台主機130,藉以透過平台主機130取得病患投保之保險公司的公司識別資料。The
醫療主機120負責取得病患的同意資料,並儲存所取得的同意資料,並可以將同意資料作為病患資料的一部份。其中,病患的同意資料包含病患的身分識別資料、病患允許提供的時間區間(及病因)等資料及經過病患(或病患家屬)簽署的病歷調查同意書等文件,其中,同意資料可以包含紙本文件的掃描檔或影像檔,也可以是以文字格式記載內容並包含簽章影像檔的檔案或經過數位簽章之以文字格式記載內容的檔案等,但同意資料的形式並不以上述為限。在部分的實施例中,醫療主機120可以將同意資料轉換為特定的格式後儲存。The
醫療主機120也可以接收平台主機130所傳送的身分識別資料,並可以依據所接收到之身分識別資料取得所表示之病患在同意資料中之時間區間的病歷資料,亦可以依據所讀出之病歷資料產生診斷證明資料(如由病歷資料中讀出看診日期與診療記錄等資料並將所讀出之資料以預定格式排列為診斷證明資料),及可以將所產生之診斷證明資料及與病患相關的資料做為病患資料傳送至平台主機130。其中,與病患相關的資料,例如同意資料等,但本創作並不以為限。The
在部分的實施例中,醫療主機120也可以先判斷所接收自平台主機130的身分識別資料是否與預先建立之同意資料相符,若存在與接收自平台主機130之身分識別資料相符的同意資料,則醫療主機120可以依據身分識別資料取得所表示之病患的病患資料,而若沒有同意資料與接收自平台主機130的身分識別資料相符,則醫療主機120將可以不取得病患資料。In some embodiments, the
醫療主機120也負責將所讀出的病患資料傳送至平台主機130。一般而言,醫療主機120可以透過數位信封將病患資料傳送給平台主機130。The
平台主機130可以接收保險伺服器151所傳送的電子保單,也可以對所接收到的電子保單簽章,還可以儲存經過簽章的電子保單。平台主機130也可以產生所接收到之電子保單的存證資料,並可以將所產生的存證資料發布到聯盟區塊鏈141中,藉以透過聯盟區塊鏈141存證所接收到的電子保單。The
平台主機130可以接收客戶端110所傳送的身分識別資料,並可以由所維護之客戶投保記錄中讀出提供與所接收到之身分識別資料對應的保單資料之保險公司的公司識別資料,及可以將所取得之公司識別資料傳送給客戶端110。平台主機130所維護之客戶投保記錄可以儲存多間保險公司之所有投保人投保的保單資料。The
平台主機130負責取得理賠申請資料。平台主機130所取得的理賠申請資料可以是由客戶端110或保險伺服器151所傳送。在部分的實施例中,平台主機130也可以判斷理賠申請資料中包含非提供傳送理賠申請資料之保險伺服器151的保險公司之公司識別資料時,將所取得的理賠申請資料傳送給與理賠申請資料中所包含之公司識別資料對應的其他保險公司所提供的保險伺服器152。The
平台主機130也負責依據理賠申請資料中的身分識別資料向醫療主機120請求病患資料。一般而言,平台主機130可以透過數位信封將身分識別資料傳送給醫療主機120,並可以接收醫療主機120透過數位信封所傳回的病患資料,藉以提高資料的安全性,但本創作並不限於透過數位信封傳送病患資料,例如,平台主機130也可以使用明文將身分識別資料傳送給醫療主機120,並可以接收醫療主機120透過數位信封所傳回的病患資料;又如,在安全性許可的環境下,平台主機130也可以使用明文將身分識別資料傳送給醫療主機120,並接收醫療主機120以明文傳送的病患資料。The
平台主機130也負責產生包含接收自客戶端110或保險伺服器151之理賠申請資料及接收自醫療主機120之病患資料的病患理賠資料,並負責將所產生的病患理賠資料發布到聯盟區塊鏈141。在部分的實施例中,平台主機130還可以先將病患資料進行特定運算以產生運算值,再將所產生的運算值發布到公開區塊鏈145。The
平台主機130也可以在理賠申請資料中註記病患不為保戶時,依據理賠申請資料中之通訊資料傳送表示病患不為保戶之通知訊息至客戶端110之使用者(通常也就是病患或病患家屬)。其中,通訊資料可以是手機號碼、電子郵件帳號、即時通訊帳號等,但本創作並不以此為限。The
平台主機130也可以將保險伺服器151轉入虛擬帳戶的法幣值轉換為與保險伺服器151對應的虛擬幣值。平台主機130可以提供應用程式介面給保險伺服器151,使保險伺服器151可以透過應用程式介面將法幣轉帳至提供平台主機130之機構向銀行所申請的虛擬帳戶中。The
平台主機130也可以在接收到醫療主機120所傳送之病患資料時,對與醫療主機120對應的虛擬幣值增加對應數值;平台主機130也可以在將病患資料傳送至保險伺服器151時,或將病患理賠資料發布至聯盟區塊鏈中時,或將運算值發布至公開區塊鏈中時,平台主機130可以對與保險伺服器151對應的虛擬幣值減少對應數值。The
保險伺服器151可以產生與保戶簽訂的電子保單,並可以將所產生的電子保單傳送給平台主機130。The
保險伺服器151負責取得理賠申請資料。保險伺服器151可以接收客戶端110所產生之理賠申請資料,也可以接收平台主機130以數位信封所轉送之理賠申請資料。The
保險伺服器151也可以判斷所取得之理賠申請資料中之身分識別資料所表示的病患是否為保戶。例如,保險伺服器151可以判斷保戶資料中是否存在與理賠申請資料中之身分識別資料相同的身分識別資料,若是,則表示身分識別資料所表示的病患為保戶;反之,保戶資料中不存在與理賠申請資料中之身分識別資料相同的身分識別資料,則表示身分識別資料所表示的病患不為保戶,但保險伺服器151判斷與理賠申請資料中之身分識別資料所表示的病患是否為保戶方式並不以上述為限,例如,保險伺服器151也可以是否存在包含與理賠申請資料中之身分識別資料的電子保單,並可以判斷存在的電子保單是否到期及/或是否有效,當存在的電子保單尚未到期且依然有效時,保險伺服器151可以判斷理賠申請資料中之身分識別資料所表示的病患為保戶,反之,當不存在包含與理賠申請資料中之身分識別資料的電子保單,或電子保單已到期或電子保單無效時,保險伺服器151可以判斷理賠申請資料中之身分識別資料所表示的病患不為保戶。The
保險伺服器151可以在判斷理賠申請資料中之身分識別資料所表示的病患為保戶時,再將理賠申請資料中註記病患為保戶;保險伺服器151也可以在判斷理賠申請資料中之身分識別資料所表示的病患不為保戶時,在理賠申請資料中註記病患不為保戶。When the
保險伺服器151也負責取得病患資料,並負責依據所取得的病患資料執行理賠作業。 一般而言,保險伺服器151可以接收平台主機130由醫療主機120所取得的病患資料。The
保險伺服器151也可以依據所接收到之理賠申請資料所包含的身分識別資料讀取預先存留的電子保單,並依據所讀出之電子保單中的業務員資訊傳送關懷資訊給業務員。其中,關懷資訊可以表示保戶受傷或生病,並可以包含能夠讓業務員找到保戶的資料(例如保戶識別資料等);業務員資訊可以是業務員的通訊資料,也可以是業務員在保險公司的業務識別資料,保險伺服器151可以直接依據通訊資料將關懷資訊傳送給業務員所使用的手機或平板等行動裝置,也可以依據業務識別資料讀出相對應之業務員的通訊資料後,再依據通訊資料將關懷資訊傳送給業務員所使用的行動裝置。The
接著以一個實施例來解說本創作的系統運作,並請參照「第2A圖」本創作所提之由整合平台取得理賠資料並由區塊鏈存證之流程圖。Next, an example is used to explain the operation of the system of this creation, and please refer to the flowchart of "Figure 2A" in this creation for obtaining claims data from the integrated platform and depositing it on the blockchain.
若病患在生病或受傷前購買保險公司的保險商品,則保險伺服器151可以產生病患所購買之保險商品的電子保單。在病患到醫療機構看診後希望針對所購買之保險商品申請理賠時,病患或病患家屬可以選擇使用本創作進行理賠申請,則病患可以在醫療機構簽署病歷調查同意書,使得醫療主機120可以取得同意資料(步驟210)。在本實施例中,假設醫療機構的醫事人員可以將病歷調查同意書掃描為影像檔後,將影像檔與病患的病患編號(病患在醫療機構的識別碼)上傳到醫療主機120中。If the patient purchases an insurance product from an insurance company before becoming ill or injured, the
接著,病患或病患家屬可以操作客戶端110,使得客戶端110產生理賠申請資料(步驟220)。在本實施例中,假設病患或病患家屬可以操作客戶端110連線到任何支援本創作之保險公司所提供的保險伺服器151或平台主機130,保險伺服器151或平台主機130可以提供客戶端110顯示理賠申請資料的輸入介面。在輸入介面中可以提供病患或病患家屬輸入身分識別資料,也可以提供病患或病患家屬輸入或選擇看診的醫療機構。客戶端110也可以提供病患或病患家屬輸入申請理賠的保險公司。Then, the patient or the patient's family member can operate the
在客戶端110產生理賠申請資料後,保險伺服器151與平台主機130可以取得理賠申請資料(步驟230)。在本實施例中,假設客戶端110可以將理賠申請資料傳送給保險伺服器151,保險伺服器151可以在接收到理賠申請資料後,將所接收到的理賠申請資料加密,並將加密後的理賠申請資料及理賠申請資料中的身分識別資料傳送給平台主機130;客戶端110也可以將理賠申請資料傳送給平台主機130,並由平台主機130依據理賠申請資料中的公司識別資料將理賠申請資料轉送給與公司識別資料對應的保險伺服器151,保險伺服器151可以在接收到理賠申請資料後,將所接收到的理賠申請資料加密,並將加密後的理賠申請資料傳回給平台主機130。其中,保險伺服器151可以將理賠申請資料中的個資以無法還原的方式加密,並將理賠申請資料中的其他內容以可以還原的方式加密。After the
另外,在保險伺服器151取得理賠申請資料後,保險伺服器151還可以如「第2B圖」所示之流程,先依據理賠申請資料中所包含之身分識別資料判斷身分識別資料所表示的病患是否為保戶(步驟241),例如,保險伺服器151可以先依據身分識別資料判斷是否存在對應的保單,再判斷保單是否到期或有效。若存在與身分識別資料對應的保單,且該保單尚未到期且有效,則保險伺服器151可以在理賠申請資料中加入表示身分識別資料所表示的病患為保戶的註記;若不存在與身分識別資料對應的保單,或存在與身分識別資料對應的保單,但該保單已到期或已無效,則保險伺服器151可以在理賠申請資料中加入表示身分識別資料所表示的病患不為保戶的註記。In addition, after the
在平台主機130接收到理賠申請資料後,可以將身分識別資料傳送給與理賠申請資料中所記錄之醫療機構的機構識別資料對應的醫療主機120,藉以向醫療主機120請求病患資料(步驟250)。在本實施例中,由於理賠申請資料經過加密,平台主機130可以解密理賠申請資料以取得理賠申請資料中的機構識別資料。其中,若理賠申請資料中註記病患不為保戶,則平台主機130可以依據理賠申請資料中所包含的通訊資料將所產生的通知訊息傳送給客戶端110的使用者,也就是傳送通知訊息到病患或病患家屬所使用的客戶端110或手機等計算設備(步驟245)。After the
醫療主機120在接收到平台主機130所傳送之病患的身分識別資料後,可以依據所接收到的身分識別資料取得病患的同意資料,並依據身分識別資料取得同意資料中定義之時間區間內的病歷資料,並可以依據所取得之病歷資料產生診斷證明資料,及產生包含所產生之診斷證明資料與同意資料的病患資料,並將所產生的病患資料傳回平台主機130(步驟260)。After the
在平台主機130取得病患資料後,平台主機130可以將病患資料傳送給保險伺服器151,保險伺服器151在接收到病患資料後,可以依據所取得的病患資料執行理賠作業(步驟270)。After the
同樣在平台主機130或保險伺服器151取得病患資料後,平台主機130或保險伺服器151可以產生包含理賠申請資料與病患資料的病患理賠資料,並可以將病患理賠資料發布到聯盟區塊鏈141中(步驟281)。另外,平台主機130也可以將病患理賠資料進行運算以產生運算值,並可以將所產生的運算值發布到公開區塊鏈145中(步驟285)。Similarly, after the
如此,透過本創作,對於病患或病患家屬,可以無需花費等待取得病歷資料的時間,且僅需進行一次理賠申請即可使所有保險公司受理;對於醫療機構透過平台主機即可傳送病患資料給所有保險公司;對於保險公司可以降低資料不實的風險。In this way, through this creation, for patients or their family members, there is no need to spend time waiting to obtain medical records, and only one claim application can be accepted by all insurance companies; for medical institutions, patients can be sent through the platform host. The information is given to all insurance companies; for insurance companies, the risk of false information can be reduced.
上述實施例中,在保險伺服器151依據病患資料執行理賠作業(步驟270)後,保險伺服器151可以依據理賠申請資料取得電子保單,並可以依據電子保單中的業務員資訊傳送關懷資訊置業務員的行動裝置(步驟290),使得業務員可以主動關懷病患。In the above embodiment, after the
另外,上述實施例中,更可以如「第3圖」之流程所示,在保險伺服器151使用本創作之服務前,保險伺服器151可以將法幣值由與保險伺服器151對應的帳戶轉帳至與平台主機130對應的虛擬帳戶(步驟310),平台主機130可以將轉入虛擬帳戶的法幣值轉換為相對應的虛擬幣值(步驟320)。例如,平台主機130可以提供應用程式介面給保險伺服器151,保險伺服器151可以透過平台主機130所提供的應用程式介面將一定金額的新台幣由所屬保險公司的帳號轉帳至提供平台主機130之機構向銀行所申請的虛擬帳戶中,使得平台主機130可以將轉入虛擬帳戶之新台幣的金額轉換為與保險伺服器151對應之虛擬幣的金額。In addition, in the above-mentioned embodiment, as shown in the process of "Figure 3", before the
在平台主機130將保險伺服器151轉入虛擬帳戶的法幣值轉換為相對應的虛擬幣值(步驟320)後,保險伺服器151便可以使用本創作,其中,當平台主機130由醫療主機120取得病患資料(步驟250)後,平台主機130可以對與醫療主機120對應的虛擬幣值增加對應數值,提供醫療主機120的醫療機構可以依據虛擬幣值向提供與平台主機130對應之虛擬帳戶的銀行結算,藉以將虛擬帳戶的虛擬幣值兌換為新台幣(步驟350);而平台主機130將病患資料傳送至保險伺服器151(步驟270)後,或將病患理賠資料發布至聯盟區塊鏈中(步驟281)後,或將運算值發布至公開區塊鏈中(步驟285)後,平台主機130可以對與保險伺服器151對應的虛擬幣值減少對應數值(步驟360)。After the
綜上所述,可知本創作與先前技術之間的差異在於具有客戶端產生包含病患之身分識別資料的理賠申請資料後,平台主機依據身分識別資料向醫療主機請求病患資料並將病患資料提供給保險伺服器以進行理賠,並將包含理賠申請資料及病患資料之病患理賠資料加密後發布到區塊鏈之技術手段,藉由此一技術手段可以來解決先前技術所存在被保險人需要花費額外時間向各家保險公司申請理賠且各保險公司需要花費成本與各醫療機構簽約連線的問題,進而達成讓被保險人以更少的時間完成理賠申請及在保險公司與多個醫療機構及醫療機構與多個保險公司間提供安全與方便之資料傳遞機制的技術功效。To sum up, it can be seen that the difference between this creation and the previous technology is that after the client generates the claim application data containing the patient’s identification data, the platform host requests the patient data from the medical host based on the identification data and sends the patient The data is provided to the insurance server for claim settlement, and the patient claim data including the claim application data and patient data is encrypted and published to the blockchain. This technical method can solve the problems of the previous technology. The insurer needs to spend extra time to apply for claims to various insurance companies and each insurance company needs to spend the cost to contract and connect with various medical institutions, so as to allow the insured to complete the claim application in less time and to contact the insurance company. The technical effect of providing a safe and convenient data transmission mechanism between a medical institution and a medical institution and multiple insurance companies.
再者,本創作之由整合平台取得理賠資料並由區塊鏈存證之系統所包含的各裝置/設備,可實現於硬體、或硬體與軟體之組合中,亦可在電腦系統中以集中方式實現或以不同元件散佈於若干互連之電腦系統的分散方式實現。Furthermore, each device/equipment included in the system in which claims data is obtained from the integrated platform and certified by the blockchain in this creation can be implemented in hardware, or a combination of hardware and software, or in a computer system It is implemented in a centralized manner or in a decentralized manner in which different components are distributed among several interconnected computer systems.
雖然本創作所揭露之實施方式如上,惟所述之內容並非用以直接限定本創作之專利保護範圍。任何本創作所屬技術領域中具有通常知識者,在不脫離本創作所揭露之精神和範圍的前提下,對本創作之實施的形式上及細節上作些許之更動潤飾,均屬於本創作之專利保護範圍。本創作之專利保護範圍,仍須以所附之申請專利範圍所界定者為準。Although the implementation method disclosed in this creation is as above, the content described is not used to directly limit the scope of patent protection of this creation. Any person with ordinary knowledge in the technical field to which this creation belongs, without departing from the spirit and scope of this creation, makes a little modification in the form and details of the implementation of this creation, and it belongs to the patent protection of this creation. scope. The scope of patent protection for this creation shall still be subject to the scope of the attached patent application.
110:客戶端 120:醫療主機 130:平台主機 141:聯盟區塊鏈 145:公開區塊鏈 151、152:保險伺服器 步驟210:醫療主機取得同意資料 步驟220:客戶端取得身分識別資料,及產生包含身分識別資料之理賠申請資料 步驟230:保險伺服器及平台主機取得理賠申請資料 步驟241:保險伺服器依據身分識別資料判斷病患是否為保戶 步驟245:平台主機依據理賠申請資料中之通訊資料傳送通知訊息至客戶端之使用者 步驟250:平台主機依據身分識別資料向醫療主機請求病患資料 步驟260:醫療主機依據同意資料中之時間區間產生病患資料,並將病患資料傳給平台主機 步驟270:平台主機將病患資料傳送給保險伺服器,保險伺服器依據病患資料執行理賠作業 步驟281:平台主機或保險伺服器產生包含理賠申請資料及病患資料之病患理賠資料,並將病患理賠資料發布至聯盟區塊鏈中 步驟285:平台主機對病患理賠資料進行運算以產生運算值,並將運算值發布至公開區塊鏈中 步驟310:保險伺服器將法幣值轉帳至與平台主機對應之虛擬帳戶 步驟320:平台主機將法幣值轉換為與保險伺服器對應之虛擬幣值 步驟350:平台主機於向醫療主機請求病患資料後,增加與醫療主機對應之虛擬幣值 步驟360:平台主機於傳送病患資料至保險伺服器後,或於將病患理賠資料發布至聯盟區塊鏈中候,或將運算值發布至公開區塊鏈中候,對與保險伺服器對應之虛擬幣值減少對應數值 110: client 120: medical host 130: platform host 141: Consortium Blockchain 145: Public blockchain 151, 152: Insurance server Step 210: The medical host obtains consent information Step 220: The client obtains the identification data, and generates a claim application data containing the identification data Step 230: Insurance server and platform host obtain claim application information Step 241: The insurance server determines whether the patient is the insured person based on the identification data Step 245: The platform host sends a notification message to the client user based on the communication data in the claim application data Step 250: The platform host requests patient information from the medical host based on the identity information Step 260: The medical host generates patient data according to the time interval in the consent data, and transmits the patient data to the platform host Step 270: The platform host sends the patient data to the insurance server, and the insurance server performs the claim settlement operation based on the patient data Step 281: The platform host or insurance server generates patient claim data including claim application data and patient data, and publishes the patient claim data to the alliance blockchain Step 285: The platform host performs calculations on the patient claims data to generate calculation values, and publishes the calculation values to the public blockchain Step 310: The insurance server transfers the fiat currency value to the virtual account corresponding to the platform host Step 320: The platform host converts the legal currency value into the virtual currency value corresponding to the insurance server Step 350: The platform host increases the virtual currency value corresponding to the medical host after requesting patient information from the medical host Step 360: After the platform host sends the patient data to the insurance server, or publishes the patient claims data to the alliance blockchain, or publishes the calculated value to the public blockchain, it matches the insurance server The corresponding virtual currency value is reduced by the corresponding value
第1圖為本創作所提之由整合平台取得理賠資料並由區塊鏈存證之系統架構圖。 第2A圖為本創作所提之由整合平台取得理賠資料並由區塊鏈存證之流程圖。 第2B圖為本創作所提之透過整合平台與區塊鏈取得資料進行理賠之附加流程圖。 第3圖為本創作所提之平台主機計算與保險伺服器對應之虛擬幣之流程圖。 Figure 1 is a system architecture diagram of the creation proposed by the integrated platform to obtain claims data and deposit it on the blockchain. Figure 2A is the flow chart of the creation of the claim data obtained from the integrated platform and stored on the blockchain. Figure 2B is an additional flow chart of the creation of claims through the integration platform and blockchain to obtain data. Figure 3 is the flow chart of the platform host computing the virtual currency corresponding to the insurance server mentioned in the creation.
110:客戶端 110: client
120:醫療主機 120: medical host
130:平台主機 130: platform host
141:聯盟區塊鏈 141: Consortium Blockchain
145:公開區塊鏈 145: Public blockchain
151、152:保險伺服器 151, 152: Insurance server
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| TWM614808U true TWM614808U (en) | 2021-07-21 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| TWI848384B (en) * | 2022-09-30 | 2024-07-11 | 兆豐國際商業銀行股份有限公司 | Integrated insurance system and method thereof |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| TWI848384B (en) * | 2022-09-30 | 2024-07-11 | 兆豐國際商業銀行股份有限公司 | Integrated insurance system and method thereof |
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