In the past few years, Nanning establishes an “Intelligent Medical Insurance” platform relying on big data analysis, whole process supervision and multi-dimensional evaluation to actively explore and promote intelligent monitoring work of medical insurance. The platform realizes the examination and analysis of every medical expense, the real-time monitoring of every medical behavior, and the comprehensive evaluation of every designated medical institution, effectively preventing the leakage of medical insurance funds.
By the end of July, 2018, the platform has examined a total of 7.832 billion yuan of medical expenses occurred in medical treatment of insured persons in the whole city, realizing 100% examination of medical expenses; assisted the examination and refused to pay the violation fee of 9.977 million yuan; and assisted the comprehensive appraisal and refused to pay the violation fee of 30.9692 million yuan. All of the above reduced expenditure of medical insurance funds of 40.9462 million yuan. The growth rate of pooling funds payment in city hospitalization decreased from 13% to 10%. All in all, the platform of “Intelligent Medical Insurance” has built up the reproducible “Nanning Experience”.