Beijing fully launches the [Medical Insurance Electronic Settlement Statement]. Kailing Technology helps hospitals: automated invoicing + electronic settlement statement sending/uploading, an integrated full-process solution

As the Beijing Municipal Medical Insurance Bureau fully implements electronic management of medical outpatient charging invoices, traditional paper settlement statements are gradually exiting the stage of history. According to the latest requirements, designated medical institutions in Beijing need to provide insured persons with electronic settlement statements in three formats including PDF, OFD, and XML, achieving simultaneous issuance and transmission of electronic medical charging invoices and electronic medical insurance settlement statements. Against this policy background, Kailing Technology responded actively and deployed quickly, launching an integrated full-process automation solution for electronic invoices and medical insurance settlement statements for medical institutions, helping hospitals easily respond to system transformation and business upgrades.

I. Policy Background and Business Challenges

The Beijing Municipal Medical Insurance Bureau explicitly requires that all designated medical and pharmaceutical institutions complete information system interface transformation, upload the full volume of electronic medical charging invoices (including the self-paid portion) to the Beijing Medical Insurance E-Invoice Center, and obtain medical insurance electronic settlement statements in real time. In addition, the policy also covers multiple scenarios such as inpatient care, pre-hospital emergency care, prenatal examinations, and for-profit institutions, requiring all relevant units to complete system adaptation within the specified time and to regularly accept progress notifications and supervision.

For hospitals, this involves not only deep integration with the medical insurance platform, but also electronic seal integration, unified data standards,Multiple systemsand multiple other challenges; especially for organizations with heavy pressure on information systems and tight development resources, the transformation timeline is tight and the tasks are heavy.

II. Kailing Technology integrated solution: automated invoicing + seamless flow of electronic settlement statements

In response to Beijing's medical insurance policy requirements and the actual pain points of hospitals, Kailing Technology, with automation, integration, and full adaptation at its core, has built a full-process solution from electronic document generation to settlement statement upload and patient outreach, precisely covering every step required by policy.

1. Automated invoicing: compliant generation + full upload, all in one step

Kailing Technology's automated invoicing module deeply conforms to the Shouxin standard interface specifications, achieving "data collection-Format generation-Compliance verification-Closed-loop management of "full upload":

▪ Intelligent collection of all data:Seamlessly integrate with hospital HIS systems to automatically capture medical charging data across full scenarios such as outpatient and inpatient services (including self-pay items), without manual entry, avoiding data omissions or errors;

▪ Automatic generation of compliant formats:According to policy requirements, the system automatically generates electronic files in three standard formats: PDF, PDF, and XML, among which the XML file strictly matches the financial electronic ticket data specification, providing precise data support for the "regulatory agency code" query of municipal institutions;

▪ Intelligent validation and official seal overprinting:Built-in compliance validation engine, automatically checks the accuracy of the "regulatory agency code" entry, and supports automatic overprinting according to the hospital's existing official seal format, ensuring electronic settlement statements meet policy validity requirements;

▪ Direct connection to the electronic invoice center for upload:The system is directly connected with the Beijing Medical Insurance Electronic Invoice Center. After electronic invoices are generated, the upload process is automatically triggered without manual intervention. It also records upload status and sets "retry reminders" and "exception warnings" for delayed feedback, ensuring uninterrupted data upload.

2. Sending/uploading electronic settlement statements: two-way reach, efficient and controllable

In the circulation and distribution of electronic settlement statements, Kailing Technology builds a two-way service system "facing medical insurance centers + facing patients":

▪ Medical insurance side:Full-process visual management。Real-time synchronization of settlement statement generation progress at the Beijing Medical Insurance Electronic Invoice Center, with generation status (pending generation/generated/abnormal) clear at a glance; after settlement statement feedback, the system automatically archives and associates the corresponding electronic invoice, supporting quick queries by date, patient ID, and other dimensions, facilitating hospitals' response to regular notification inspections by the municipal medical insurance center;

▪ Patient side:Convenient multi-channel reach。After patients complete settlement, the system can automatically push query/download links for medical insurance electronic settlement statements and electronic invoices through multiple channels such as SMS, hospital official accounts, and electronic medical visit card apps, without the need for patients to apply actively, truly realizing "electronic documents upon settlement" and solving the problems of traditional paper documents being easily lost and inconvenient to query.

3. Full-scenario adaptation: Covers special requirements without additional modification

For special institutions and scenarios mentioned in the policy, the Kailing Technology solution presets customized adaptation modules to avoid repeated investment by hospitals:

▪ Seamless HIS system integration:Whether it is an institution upgrading its existing HIS system or replacing it with a new HIS system, the solution can provide standardized interfaces to quickly complete data interoperability without reconstructing the hospital's existing informatization architecture;

▪ Customized services for special institutions:Provide for-profit institutions with linked transformation of tax electronic invoices and medical insurance electronic settlement statements, ensuring tax compliance and medical insurance requirements are implemented simultaneously; forHasCustomized integrated module of "real-time settlement of prenatal examinations + electronic settlement statements" for qualified midwifery institutions to meet the "dual transformation" needs; optimized real-time settlement data synchronization logic for pre-hospital emergency institutions to ensure the timeliness of electronic bills and settlement statement generation;

III. Core value of the solution: cost reduction, efficiency improvement, and better experience

Kailing Technology's integrated solution not only helps hospitals "meet policy requirements," but also creates practical value from the three dimensions of operational efficiency, patient experience, and compliance management:

▪ For hospitals:Reduce costs and increase efficiency, worry-free compliance。Automated processes replace manual invoicing, uploading, distribution, and other steps, saving paper invoice printing, storage, and mailing costs each year while reducing manual operation time by more than 70%; the system has built-in policy compliance verification logic that matches the latest requirements of the Medical Insurance Bureau in real time, avoiding notification risks caused by data errors or upload delays;

▪ For patients:Convenient and transparent, upgraded experience。Patients do not need to wait for paper documents; after settlement, they can obtain electronic settlement statements and invoices via mobile phone, and query, download, and print them at any time, solving the pain point of "documents lost after medical treatment cannot be reimbursed"; the medical insurance expense breakdown results are clearly presented, allowing patients to see the medical insurance reimbursement details at a glance;

▪ For medical insurance:Data interconnection, improving regulatory efficiency。Through standardized interfaces and full data upload, it helps the Beijing Medical Insurance Electronic Invoice Center achieve precise control over the city's medical charging data, provides data support for medical insurance fund supervision and policy optimization, and promotes the digital upgrade of the medical security system.

The full rollout of electronic medical insurance settlement statements isAn important measure to improve the convenience and transparency of medical insurance services. Kailing Technology is willing to become a trusted technology partner for medical institutions, helping all units smoothly complete system upgrades, achieve "more data running, less patient errands," and provide insured persons with a higher-quality and more efficient medical insurance service experience.

If your institution is undergoing system transformation or wishes to learn more about solution details, you are welcomeandKailing TechnologyObtainContact. Let us jointly help advance the electronicization process of Beijing medical insurance smoothly!

Attached:Beijing Medical Insurance Expense Settlement Statement（Electronic）Style

Policy andStyleImage source: Jiedi Medical Services; deleted upon request.

As a comprehensive business-finance-tax digitalization solution service provider, Kailing Technology provides business-finance-tax management digital transformation products and operational services for various government agencies, institutions, and large, medium, and small enterprises. The product line includes:

Solutions for sales contract management system, procurement contract management system, fully digitalized Leqi interface project, automatic output VAT invoicing system, invoice issuance for individuals system, employee expense control and reimbursement system, input VAT invoice management system, supply chain collaborative reconciliation system, imaging OCR recognition system, automatic financial bookkeeping system, electronic accounting archives system and other businesses, comprehensively advancing the digitalization process across various fields.

If you have any business-finance-tax digital transformation needs, welcome to contact us. Beijing Kailing Technology will serve you wholeheartedly.