KR-102963462-B1 - Health checkup cost settlement system for employee welfare and interface display method

KR102963462B1KR 102963462 B1KR102963462 B1KR 102963462B1KR-102963462-B1

Abstract

A method for settling health checkup costs for employee welfare, performed by a processor, is disclosed. The above method for settling health checkup costs for employee welfare comprises the steps of: receiving one or more health checkup approval orders and one or more health checkup cancellation orders for any health checkup order; setting the settlement status of the said arbitrary health checkup order to an unconfirmed state; identifying orders for which the order arrival order is difficult to distinguish temporally because the difference between the order arrival times of the received one or more health checkup approval orders and the received one or more health checkup cancellation orders exists within a preset time range; generating multiple scenarios representing various order arrival orders for the orders for which the order arrival order is difficult to distinguish temporally; calculating the number of order status changes in which the order status set for the said arbitrary health checkup order changes differently according to the arrival order of the received one or more health checkup approval orders and the received one or more health checkup cancellation orders for the generated multiple scenarios; and, for the generated multiple scenarios, the number of said health checkup approval orders that arrived after the said health checkup approval order, or the number of said health checkup cancellation orders that arrived after the said health checkup cancellation order The method includes the steps of counting the number of orders; calculating the elapsed time since the last health checkup approval order or the last health checkup cancellation order for the plurality of generated scenarios; calculating a scenario-specific weight value by weightedly combining the number of order status changes calculated for each of the plurality of generated scenarios, the counted number, or the calculated elapsed time; determining the settlement status of the arbitrary health checkup order as the undetermined state or the confirmed state by synthesizing the results of comparing the scenario-specific weight values with a preset reference value; and performing cost settlement for the arbitrary health checkup determined as the confirmed state and limiting cost settlement for the arbitrary health checkup determined as the undetermined state.

Inventors

송동진
박영환

Assignees

이제너두 주식회사

Dates

Publication Date: 20260513
Application Date: 20260127

Claims (7)

In a method for settling health checkup costs for employee welfare performed by a processor, A step of receiving one or more health checkup approval orders and one or more health checkup cancellation orders for any health checkup order; A step of setting the settlement status of the above arbitrary health checkup order to an unconfirmed state; A step of identifying orders for which the order arrival order is difficult to distinguish in time, such that the difference between the order arrival times of one or more received health checkup approval orders and one or more received health checkup cancellation orders exists within a preset time range; A step of generating multiple scenarios representing various order arrival sequences for orders for which the order arrival sequence is difficult to distinguish chronologically; A step of calculating the number of order status changes in which the order status set for any health checkup order changes differently according to the arrival order of one or more received health checkup approval orders and one or more received health checkup cancellation orders for the plurality of scenarios generated above; A step of counting the number of health checkup approval orders reached after the health checkup approval order, or the number of health checkup cancellation orders reached after the health checkup cancellation order, for the plurality of scenarios generated above; A step of calculating the elapsed time since the last health checkup approval order or the last health checkup cancellation order for the plurality of scenarios generated above; A step of calculating a scenario-specific weight value by weightedly combining the number of order status changes calculated for each of the plurality of scenarios generated above, the counted number, or the calculated elapsed time, and determining the settlement status of the arbitrary health checkup order as an unconfirmed state or a confirmed state by synthesizing the results of comparing the scenario-specific weight value with a preset reference value; and A method for settling health checkup costs for employee welfare, comprising the step of performing cost settlement for any health checkup determined to be in a confirmed state, and limiting cost settlement for any health checkup determined to be in an unconfirmed state.
In paragraph 1, the step of generating the plurality of scenarios is, A step of calculating a first probability value representing the probability that the received health checkup approval order and the received health checkup cancellation order were due to a change in the user's will; A step of calculating a second probability value representing the probability that the received health checkup approval order and the received health checkup cancellation order have a distorted order of arrival due to network delay; and A method for settling health checkup costs for employee welfare, comprising the step of comparing the first probability value and the second probability value, and, based on the comparison result, not generating all possible order arrival orders, but selectively generating only scenarios representing representative order arrival orders that are likely to affect the determination of the settlement status.
In paragraph 2, the first probability value is For the above arbitrary health checkup order, a feature vector including time interval characteristics, repeating pattern characteristics of order events, and event occurrence density characteristics extracted from the above received health checkup approval order and the above received health checkup cancellation order is calculated as a posterior probability based on a probability distribution corresponding to the order event generated by the user's change of intent, and The above second probability value is, A feature vector including the difference between the occurrence time and arrival time of the received health checkup approval order and the received health checkup cancellation order, the discrepancy characteristic of the order reception order, and the network delay variance characteristic is calculated as the posterior probability that it belongs to the probability distribution corresponding to the order event caused by the network delay, and A method for settling health checkup costs for employee welfare, wherein the above first probability value and the above second probability value are used as judgment indicators to limit the type and range of order arrival scenarios to be generated.
In paragraph 3, the step of comparing the first probability value and the second probability value, and selectively generating only scenarios representing representative order arrival orders that are highly likely to affect the settlement status determination, without generating all possible order arrival orders based on the comparison result, When the above first probability value is greater than the above second probability value, a scenario representing the order arrival order based on the user's change of intent is optionally generated, and When the second probability value is greater than the first probability value, a scenario in which the order arrival order is distorted based on the network delay is selectively generated, and A method for settling health checkup costs for employee welfare, comprising the step of generating a mixed scenario configured such that when the difference between the first probability value and the second probability value is less than an arbitrary value, some of the health checkup approval orders and health checkup cancellation orders are assumed to have occurred based on a change in user intent, and the remaining some are assumed to have a distorted order of arrival due to network delay.
In paragraph 1, Based on the weight value calculated for each of the plurality of scenarios or the corresponding number of order status changes and final order status, in some of the plurality of scenarios, the final order status of the arbitrary health checkup order is determined to be an approved state, and in other scenarios, the final order status is determined to be a canceled state, or when the number of order status changes exceeds a preset allowable range, the settlement status of the arbitrary health checkup order is determined to be an unconfirmed state. A method for settling health checkup costs for employee welfare, wherein in all of the above multiple scenarios, the final order status of the above arbitrary health checkup order is determined to be the same state, the number of order status changes is within a preset allowable range, and the elapsed time after the last health checkup approval order or health checkup cancellation order is greater than or equal to a reference time, the settlement status of the above arbitrary health checkup order is determined to be the above confirmed state.
In paragraph 1, the step of generating the plurality of scenarios is, A step of calculating one or more feature values including the elapsed time since receiving the approval order, past order cancellation history, and network status information, based on the arrival time of the received health checkup approval order, when a health checkup cancellation order having the same user identifier and the same health checkup item identifier is not received within a preset time threshold from the arrival time; A step of calculating a probability value that the corresponding health checkup cancellation order was not received based on the above feature values; When the above probability value is greater than or equal to a reference value, the step of generating the corresponding health checkup cancellation order as a prediction order; and A method for settling health checkup costs for employee welfare, comprising the step of generating a first scenario including only actual received health checkup orders and a second scenario including predicted unreceived health checkup orders.
A processor that executes orders to settle health checkup costs for employee welfare; and It includes memory for storing the above commands, The above commands are, For any health checkup order, receive one or more health checkup approval orders and one or more health checkup cancellation orders, and Set the settlement status of the above arbitrary health checkup order to an unconfirmed state, and Identifying orders for which the order arrival order is difficult to distinguish in time, such that the difference between the order arrival times of one or more received health checkup approval orders and one or more received health checkup cancellation orders exists within a preset time range, and For orders where the order arrival order is difficult to distinguish chronologically, multiple scenarios representing various order arrival orders are generated, and Calculate the number of order status changes in which the order status set for any health checkup order changes differently according to the arrival order of one or more received health checkup approval orders and one or more received health checkup cancellation orders for the plurality of scenarios generated above, and For the plurality of scenarios generated above, counting the number of health checkup approval orders reached after the health checkup approval order, or the number of health checkup cancellation orders reached after the health checkup cancellation order, For the multiple scenarios generated above, the elapsed time since the last health checkup approval order or the last health checkup cancellation order is calculated, and For each of the plurality of scenarios generated above, the number of order status changes, the counted number, or the calculated elapsed time are weightedly combined to calculate a scenario-specific weight value, and the result of comparing the scenario-specific weight value with a preset reference value is combined to determine the settlement status of the arbitrary health checkup order as the undetermined state or the confirmed state. A device implemented to perform cost settlement for any health examination determined in the above-mentioned confirmed state, and to limit cost settlement for any health examination determined in the above-mentioned unconfirmed state.

Description

Health checkup cost settlement system for employee welfare and settlement method The present invention relates to a system and method for settling health checkup costs for employee welfare, and more specifically, to a system and method for settling health checkup costs for employee welfare that can prevent mis-settlement by determining the settlement status based on a scenario for approved and cancelled orders where the order of arrival is unclear. The Company provides welfare benefits to employees for the benefit of its employees, and employees may apply for and undergo health checkups using these benefits. Welfare benefits incurred by employees during the process of undergoing health checkups must be settled retrospectively. The settlement of these health checkup costs takes place among the client company requesting health checkups for the welfare of its employees, the organization operating the welfare mall site that provides services enabling the client company's employees to apply for and settle health checkups using welfare points or subsidies from the checkup company, the representative hospital that mediates the health checkups and links them to multiple examination institutions, and the examination institutions that actually perform the health checkups. In other words, multiple institutions are involved in the settlement process of health checkup costs in stages. In a structure involving multiple agencies like this, problems may arise where order information related to the approval, cancellation, or modification of health checkups is transmitted between agencies but is received out of order or in a reversed order. As a result, it is difficult to clearly determine the final status of a health checkup order, raising concerns about settlement errors, duplicate settlements, or settlement delays. Therefore, a new health checkup cost settlement system and method are required that can reasonably and consistently determine the settlement status, even in situations where the processing order of approval and cancellation orders related to health checkups is unclear in an environment involving multiple institutions. Detailed descriptions of each drawing are provided to help to more fully understand the drawings cited in the detailed description of the present invention. Figure 1 shows a block diagram of a welfare expense settlement system according to an embodiment of the present invention. FIGS. 2 and FIGS. 3 show blueprint diagrams illustrating the welfare expense settlement steps according to an embodiment of the present invention. FIG. 4 shows a diagram for explaining a method for determining a claim subject according to an embodiment of the present invention. FIG. 5 shows a diagram for explaining a method for determining a finishing target according to an embodiment of the present invention. FIG. 6 shows a diagram for explaining a method for determining the issuance target according to an embodiment of the present invention. FIG. 7 shows a diagram for explaining the remaining operations of a welfare expense settlement method according to an embodiment of the present invention. FIGS. 8 to 10 show interfaces displayed on the display of the client server illustrated in FIG. 1. FIGS. 11 to 15 show interfaces displayed on the display of the sales company server illustrated in FIG. 1. FIG. 16 shows a flowchart for explaining a method for settling welfare expenses according to an embodiment of the present invention. FIG. 17 shows a flowchart for explaining a method for determining the subject of a health checkup cost claim for a client company according to an embodiment of the present invention. FIG. 18 shows a diagram for explaining a method for predicting health checkup cancellation orders for health checkup approval orders by customer according to another embodiment of the present invention. FIGS. 19 and FIGS. 20 show interfaces displayed on the display of the sales server illustrated in FIG. 1. Specific structural or functional descriptions regarding embodiments according to the concept of the present invention disclosed herein are provided merely for the purpose of explaining embodiments according to the concept of the present invention, and embodiments according to the concept of the present invention may be implemented in various forms and are not limited to the embodiments described herein. Embodiments according to the concept of the present invention may be subject to various modifications and may take various forms; therefore, embodiments are illustrated in the drawings and described in detail in this specification. However, this is not intended to limit the embodiments according to the concept of the present invention to specific disclosed forms, and includes all modifications, equivalents, or substitutions that fall within the spirit and scope of the present invention. Terms such as "first" or "second" may be used to describe various components, but said components should not be limited by said term