健康保险核保作业制度与规则v11VIP免费

“此文件所含信息属于机密,如泄露给未得到适当授权的人,会对信诚人寿及信诚人寿的商业伙伴、客户或股东等利益造成严重影响或损害。未得到适当批准，严禁将此文件或其所含信息复制、转发或泄露给任何第三方。如有泄露,信诚人寿将保留追究责任的权利。”“Theinformationcontainedinthisdocumentisstrictlyconfidential,disclosureofwhichtounauthorizedreceiverswillcauseanadverseeffectordamagetotheinterestofCITIC-PruLife,BusinessParterners,CustomersorShareholders.Unlesswithappropriateapproval,itisstrictlyprohibitedtocopy,transferordisclosethisdocumentortheinformationcontainedthereintoanythirdparty.Ifthedisclosuredoesoccur,CITIC-PruLifeshallreservetherighttopursuetheliabilities."文档安全级别:□内部类□限制类□绝密类健康保险核保作业制度与规则信诚人寿保险有限公司总公司营运运作中心契约部√信诚人寿保险有限公司健康保险核保作业制度与规则文档安全级别：限制类2文件信息文件名称健康保险核保作业制度与规则文件类型核保作业制度与规则文件编号文件内容概要1.健康保险核保作业制度2.健康保险核保新契约/保全/理赔/续期作业规则时间2006.12.08文件起草者OnlyZhou文件归属部门总公司营运部/运作中心/核保部授权发布人员BenHuang文件修改纪录版本日期修改人员修改内容修改确认1.02006.12.08Only原稿Kevin1.12008.5.26LisaLu1、修改了自动核保作业规则2、根据数据外包项目修改了投保资料的审核要求BenHuang信诚人寿保险有限公司健康保险核保作业制度与规则文档安全级别：限制类3目录第一章健康保险核保作业制度...................................................5一、目的...............................................................................................5二、健康保险核保人资格.......................................................................5三、健康保险核保岗位职能...................................................................5四、健康保险核保人管理.......................................................................6信诚人寿保险有限公司健康保险核保作业制度与规则文档安全级别：限制类4五、健康保险核保风险管理...................................................................7第二章健康保险核保作业规则.................................................7一、总则...............................................................................................7二、新契约作业规则..............................................................................81作业流程图.....................................................................................82影像系统（CDFS系统）的作业规则...............................................93自动核保作业规则........................................................................124人工核保作业规则........................................................................12三、保全核保作业规则........................................................................151保全核保作业流程........................................................................162CDFS查询规则............................................................................163保全核保作业规则........................................................................17四、理赔核保作业规则........................................................................191理赔二次核保作业流程.................................................................202理赔核保件受理规则.....................................................................203理赔核保作业规则........................................................................21五、续期核保作业规则.............