Health Care Insurance

Contents
1. ABSTRACT 2. INTRODUCTION 3. PROJECT DICTIONAR 3.1. DATA!"O# DIA$RA%S 3.2. E&R DIA$RA%S 3.3. DATA DICTIONAR '. !OR%S ( REPORTS '.1. I)O SA%P"ES
*. BIBI"IO$RAPH

1. ABSTRACT Pro+,-e a s.ste/ 0or an or1an,2at,on that ,s ,n 3r,/ar. care. Or1an,2at,on sche-ules health chec4u3s 0or the,r cl,ents to 4ee3 close e.e on the,r r,s4 le+els -e3en-,n1 on the -,seases)3ro5le/s ,ncurre- ,n the/ .It ,s res3ons,5le 0or 0,6,n1 the a33o,nt/ents 7,th the 3h.s,c,ans8 la5s an- also ta4,n1 care o0 e/er1enc. s,tuat,ons. Features: Cl,ent Deta,ls Internal)E6ternal 3h.s,c,an Deta,ls Insurance Co/3an. Deta,ls S.ste/ User %ana1e/ent Reports: Cl,ent9s %onthl. Health Re3ort Ph.s,c,an9s cl,ent9s re3orts :Deta,l)Su//ar.; Cl,ent9s l,st -e3en-,n1 on the r,s4 le+el ",st o0 E6ternal 3h.s,c,ans atten-,n1 the cl,ents

2. INTRODUCTION The Health Care Insurance S.ste/ ,s /a,nl. -e+elo3e- to 3ro+,-e an or1an,2at,on a 7ell&-e+elo3e- s.ste/ that ,s ,n 3r,/ar. care. The or1an,2at,on sche-ules health chec4u3s 0or ,ts cl,ents to 4ee3 close e.e on the,r r,s4 le+els. Or1an,2at,on acce3ts re<uests 0ro/ the 3h.s,c,ans 7ho /a4e chec4u3s to the cl,ents an- us,n1 the re3orts8 -ocu/ents8 3rocesses the cla,/s ra,se- 5. the 3h.s,c,ans on 5ehal0 o0 the cl,ents. Th,s s.ste/ hel3s ,n eas. 0,6,n1 o0 a33o,nt/ents 0or cl,ents. Th,s s.ste/ also 3rocesses ,nsurance cla,/s an- the relate- act,+,t,es as a 3art o0 or1an,2at,on ser+,ces. Or1an,2at,on ser+es ,ts cl,ents ,n a 3ro/3t8 rel,a5le /anner8 an- the 0ee structure ,s also h,1hl. co/3et,t,+e. Th,s s.ste/ 7,ll ass,st the or1an,2at,on ,n <ual,t. cla,/ 3rocess,n1. Drawbacks of E !st!"# S$ste%: Th,s s.ste/ 7as alrea-. 3ro3ose-8 5ut the co//un,cat,on 7as throu1h the th,r- 3art.. The e6,st,n1 s.ste/ lac4e- 3ro3er co//un,cat,on8 3ro3er co&or-,nat,on anaccounta5,l,t.. Th,s lea-s to ,ne00ect,+e an- ,ne00,c,ent or1an,2at,on an- thus lea-s to lac4,n1 o0 or1an,2at,on -e+elo3/ent an- cl,ents unsat,s0act,on. The e6,st,n1 s.ste/ 7as -e-,cate- to 3a3er7or48 7h,ch lea-s to t,/e consu/,n1 an- ,ne00,c,ent ut,l,2at,on o0 resources. There /a. 5e cla,/s 0ro/ /an. c,t,2ens an- han-l,n1 each ane+er. one9s cla,/ ta4es lot o0 t,/e. There /a. also 5e so/e errors encountere7h,le collect,n1 the re<u,re- -ocu/ents. It ,s also a t,/e ta4,n1 3rocess to -el,+er the re3orts 3ersonall. or 5. 3ost to the cl,ents. so/e errors 7h,le han-l,n1 the 3a./ents an- -ues. There /a. also 5e

Nee& for Auto%at!o": No7 a -a. ,t has 5eco/e a nee- 0or e+er. c,t,2en to 1et ,nsure- on all -o/a,ns an- the health 3la.s a +,tal role. Hence th,s s.ste/ 7hen auto/ate- eases the tas4 o0 3rocess,n1 the cla,/s an- sche-ul,n1 health chec4u3s. The a33l,cat,on ,s /a-e onl,ne so that an. cl,ent re1,stere- un-er an or1an,2at,on can use the s.ste/ e00ect,+el.. ,n+ol+e- can re<uest onl,ne an- at an.t,/e. The 3a./ents to 5e collecte- are calculate- e00,c,entl. anall the ,n0or/at,on re1ar-,n1 an. -ues etc ,s care0ull. han-le-. The s.ste/ also e00ect,+el. /a,nta,ns the ,n0or/at,on o0 the cl,ents8 /ana1ers an- 3h.s,c,ans. The cl,ents an- other ent,t,es

'. (RO)ECT DICTIONAR* '.1. DATAF+O, DIA-RA.S

Admin

Admin

Manager Manager Health Care Insurance

Physician

Physician Client

+e/e0 1 DFD for A&%!"!strator

anagers !eport

Emp_profile
Pri"ileges

Web Application

Emplo#ee Profile

Admin

Login

Attendance !eport

Logout

User anagement

User ID
Change of Password

+e/e0 1 DFD for .a"a#er

!eg of Clients

Emp_profile
Ph#sician Assign

Web Application

Client !eacti"ation

Manager

Login

Alter Ph#sician

Logout

Claims

User ID
Change of Password

+e/e0 1 DFD for C0!e"t

Claims

Emp_profile
Doctor $a#s

Web Application

Pa#ments

Client

Login

Change of Ph#sician

Logout

Doctor Profile

User ID
Change of Password

+e/e0 1 DFD for (1$s!c!a"

Calendar

Emp_profile
Client Details

Web Application

Claims

Login
$uggestions

Logou t

Physician

Appointment s

User ID
Change of Password

+e/e0 1 DFD for E%p0o$ee +o#!"

Employee

Login to Web

Valid ation

Admin Manager

Option
n to web

Physician

+e/e0 2 DFD for (1$s!c!a" Ca0e"&ar

Monthly
Web Application

Calendar

Weekly

Logout

Daily Type of appointment

'.2. DATA DICTIONAR* TAB"E=NA%E !IE"DNA%E DATAT PE

ASSI$N=PH E%P=NO STATUS ATTEN=DET ATTEND=DATE E%P=NO E%O="O$IN E%P="O$OUT C"AI%=DET C"AI%=NO C"AI%=DATE C"IENT=RE$NO E%P=NO A%T=C"AI% C"AI%=!ACT -ate +archar2 :1>;:!OREI$N?E ; +archar2 :*; +archar2 :*; +archar2 :1>;:PRI%AR ?E ; -ate +archar2 :@;:!OREI$N?E ; +archar2 :1>; :!OREI$N?E ; nu/5er :@82; +archar2 :2>; +archar2 :1>;:!OREI$N?E ; nu/5er :3;

C"IENT=DAI"

C"IENT=RE$NO DAI" =START=TI%E DAI" =END=TI%E C"IENT=RE$NO C"IENT=NA%E C"IENT=ADD C"IENT=PHNO C"IENT=DOB %ANA$ER=NA%E USER=ID C"IENT=RE$NO AISIT=DATE %ONTH" =START=TI%E %ONTH" =END=TI%E C"IENT=RE$NO AISIT=DA #EE?" =START=TI%E #EE?" =END=TI%E E%P=NO E%P=NA%E

+archar2 :@; :!OREI$N?E ; +archar2 :@; +archar2 :@; +archar2 :@; :PRI%AR ?E ; +archar2 :1>; +archar2 :3>; nu/5er :1>; -ate +archar2 :1*; +archar2 :13; +archar2 +archar2 +archar2 +archar2 +archar2 +archar2 +archar2 +archar2 :@; :!OREI$N?E ; :1>; :@; :@; :@; :!OREI$N?E ; :1>; :@; :@;

C"IENT=DETAI"S

C"IENT=%ONTH"

C"IENT=#EE?"

E%P=PRO=IN!

+archar2 :1>; :PRI%AR ?E ; +archar2 :@;

E%P=DOB E%P=ADD E%P=JOB E%P=BUA E%P=ECP E%P=JB=END E%P=DATE=JOIN E%P="OC USER=ID INST=DUE=DET C"IENT=RE$NO PAID=DATE DUE=A%T C"IENT=RE$NO PAID=DARE PAID=A%T SENDER RECEIAER SUB RECEIAEDATE %ESSA$E C"IENT=RE$NO E%P=NO AISIT=DATE HISTOR SU$$ESTION REE%=NO C"AI%=NO A%T=C"AI% C"IENT=RE$NO T PE=CASE T PE=APP NU%=TI%ES

-ate +archar2 :3>; +archar2 :1>; +archar2 :2*; nu/5er :*; -ate -ate +archar2 :2>; +archar2 :1*; :!OREI$N?E ; +archar2 :@; :!OREI$N?E ; -ate nu/5er :1>82; +archar2 :@; :!OREI$N?E ; -ate +archar2 :1>; +archar2 +archar2 +archar2 -ate +archar2 :'>; :*>; :*>; :3>>;

INST=PAID=DET

%AI"=DET

PROB=SU$$

+archar2 :@; :!OREI$N?E ; +archar2:1>; :!OREI$N?E ; -ate +archar2 :*>; +archar2 :*>; +archar2 :1>; :PRI%AR ?E ; +archar2 :1>; :!OREI$N?E ; nu/5er :2; +archar2 :@; :!OREI$N?E ; +archar2 :1>; +archar2 :1*; nu/5er :2;

REE%BER=DET

T PE=O!=APP

USER=DET

USER=ID USER=NA%E USER=PASS T PE=USER USER=ID RESTRI=DA RESTRI=HRS USER=STATUS

+archar2 +archar2 +archar2 +archar2

:1*; :PRI%AR ?E ; :1*; :1>; :1>;

USER=PREA

+archar2 :1*; :!OREI$N?E ; +archar2 :1*; +archar2 :D; +archar2 :2;

3. FOR.S 4 RE(ORTS 3.1. I5O SA.(+ES