CN117911165A

CN117911165A - Fee management method and system based on APG packaging payment receipt grouping

Info

Publication number: CN117911165A
Application number: CN202311414988.1A
Authority: CN
Inventors: 赵蒙海; 李琬平
Original assignee: Shanghai Jinshida Weining Software Technology Co ltd
Current assignee: Shanghai Jinshida Weining Software Technology Co ltd
Priority date: 2023-10-27
Filing date: 2023-10-27
Publication date: 2024-04-19

Abstract

The present invention provides a cost management method and system based on APG packaged payment document grouping, including: collecting relevant data of outpatients; classifying the relevant data of the outpatients according to the type of outpatient services, and entering corresponding groups; packaging and pricing the standard fees corresponding to the groups to obtain the corresponding packaged service amount; processing the amount, and displaying the final outpatient medical data payment amount. The present invention manages the cost of the diagnosis and treatment process of outpatients, innovates the reform of outpatient medical insurance payment methods, and helps to achieve medical cost control, service quality improvement and resource allocation optimization through the classification, grouping, package pricing and outpatient settlement of diagnosis and treatment items.

Description

Fee management method and system based on APG packaging payment receipt grouping

Technical Field

The invention relates to the technical field of medical management, in particular to a fee management method and system based on APG packaging payment receipt grouping.

Background

APG (Ambulatory Payment Group) package payment, also known as clinic group payment, is a clinic medical service payment mode based on disease type grouping. The clinic service items are grouped, the clinic service items are classified according to the resource consumption and clinical consistency of diagnosis and treatment services and medicines, a relative weight is determined for each group, and then the relative weight is multiplied by basic payment unit price to obtain the payment amount of each group. The purpose of this pay mode is to control medical costs and improve medical quality and efficiency.

The background of APG package payment is mainly the following: (1) medical fees increase and patient loads increase: with the development of medical technology and the increasing health demands of people, medical expenses are continuously rising. (2) Reform the payment mode of medical service by referring to international experience (3): the outpatient APG and the hospitalized DRG are important measures for changing medical insurance payment from quantitative payment to quality payment, and can assist medical insurance funds to use, upgrade and enhance. (4) adapting to the market demand of medical services: APG package payment may prompt healthcare providers to improve quality and efficiency of service to meet patient needs, thus standing out in competition. The existing clinic payment method has the following problems: unreasonable charging items, excessive patient burden, etc.

Therefore, there is a need in the market for a fee management method and system based on APG package payment document grouping that can control medical fee, improve quality of service, and optimize resource allocation.

Disclosure of Invention

Aiming at the defects in the prior art, the invention aims to provide a fee management method and a system based on APG packaging payment receipt grouping.

The invention provides a fee management method based on APG packed payment receipt grouping, which comprises the following steps:

step S1: collecting relevant data of an outpatient;

step S2: classifying the relevant data of the outpatient according to the type of the outpatient service, and entering corresponding groups;

step S3: packaging and pricing the standard fees corresponding to the groups to obtain corresponding packaging service amounts;

step S4: and after the amount is processed, displaying the final payment amount of the outpatient medical data.

Preferably, the relevant data of the outpatient comprises basic information of the current outpatient and relevant expense data; the basic information includes diagnosis information, treatment information, and examination information;

The grouping in step S2 includes a surgical operation group, an auxiliary service group, and a medical service group;

the surgical procedure set includes significant surgical procedures for the current patient, the auxiliary service set includes a verification check for the current patient, and the medical service set includes medical medication for the current patient.

Preferably, step S2 includes:

Step S2.1: determining whether the related data of the current patient is an important operation, and if so, incorporating the operation group according to the operation or treatment type; if not, executing step S2.2:

step S2.2: judging whether the related data of the current patient is a medical treatment signal, if so, executing the step S2.3; if not, executing the step S2.4;

Step S2.3: judging whether the related data of the current patient are diagnosis, signs, symptoms and findings, if so, incorporating the related data into a surgical operation group; if not, the medical service group is included according to the main reason of the visit;

Step S2.4: judging whether the related data of the current patient is auxiliary examination or operation, if so, incorporating an auxiliary service group according to the detection type; if not, outputting error grouping information.

Preferably, step S3 includes:

Step S3.1: grouping all cases;

step S3.2: calculating the cost in the group to obtain the total cost of the corresponding APG group;

step S3.3: calculating the mechanism grade coefficient, and calculating the average cost of the APG group according to the twice weighting of the patient number and the average cost of the mechanism grade;

Step S3.4: calculating group weights, dividing the total cost of each APG disease group by the total cost of all APG disease groups to obtain the relative cost of each APG disease group, dividing the relative cost of each APG group by the average cost of all APG disease groups, and further obtaining the weight of each APG disease group;

Step S3.5: and calculating the packing payment price of each disease according to the weight of each APG disease group and the mechanism grade coefficient, wherein the formula is as follows:

APG packed payment sum = Σbase cost group weight establishment coefficient composite adjustment coefficient

Wherein, the group weight is the weight of each APG group, and the mechanism coefficient is the mechanism grade coefficient.

Preferably, the basic fee acquisition step is as follows:

Step A: obtaining the total payment amount of medical insurance, calculating the total payment amount of APG medical insurance by consulting the total fund budget of the medical insurance annual clinic and the reimbursement proportion of the medical insurance clinic, and the formula is as follows:

APG medical insurance payment sum = outpatient overall fund sum budget/medical insurance outpatient reimbursement ratio;

And (B) step (B): calculating APG total weight, namely acquiring APG weight of a case through APG group entering conditions of an outpatient throughout the year, so as to obtain APG payment total weight;

Step C: the basic cost is calculated as follows: basic charge = APG medical insurance payment sum/APG total weight.

According to the present invention, there is provided a fee management system for packaging payment documents based on APG, comprising:

Module M1: collecting relevant data of an outpatient;

module M2: classifying the relevant data of the outpatient according to the type of the outpatient service, and entering corresponding groups;

Module M3: packaging and pricing the standard fees corresponding to the groups to obtain corresponding packaging service amounts;

module M4: and after the amount is processed, displaying the final payment amount of the outpatient medical data.

The groupings described in module M2 include a surgical procedure group, an auxiliary service group, and a medical service group;

Preferably, the module M2 comprises:

Module M2.1: determining whether the related data of the current patient is an important operation, and if so, incorporating the operation group according to the operation or treatment type; if not, executing the module M2.2:

module M2.2: judging whether the related data of the current patient is a medical treatment signal, if so, executing a module M2.3; if not, executing a module M2.4;

Module M2.3: judging whether the related data of the current patient are diagnosis, signs, symptoms and findings, if so, incorporating the related data into a surgical operation group; if not, the medical service group is included according to the main reason of the visit;

module M2.4: judging whether the related data of the current patient is auxiliary examination or operation, if so, incorporating an auxiliary service group according to the detection type; if not, outputting error grouping information.

Preferably, the module M3 comprises:

Module M3.1: grouping all cases;

module M3.2: calculating the cost in the group to obtain the total cost of the corresponding APG group;

Module M3.3: calculating the mechanism grade coefficient, and calculating the average cost of the APG group according to the twice weighting of the patient number and the average cost of the mechanism grade;

Module M3.4: calculating group weights, dividing the total cost of each APG disease group by the total cost of all APG disease groups to obtain the relative cost of each APG disease group, dividing the relative cost of each APG group by the average cost of all APG disease groups, and further obtaining the weight of each APG disease group;

Module M3.5: and calculating the packing payment price of each disease according to the weight of each APG disease group and the mechanism grade coefficient, wherein the formula is as follows:

Preferably, the basic fee acquisition module is as follows:

module a: obtaining the total payment amount of medical insurance, calculating the total payment amount of APG medical insurance by consulting the total fund budget of the medical insurance annual clinic and the reimbursement proportion of the medical insurance clinic, and the formula is as follows:

Module B: calculating APG total weight, namely acquiring APG weight of a case through APG group entering conditions of an outpatient throughout the year, so as to obtain APG payment total weight;

Module C: the basic cost is calculated as follows: basic charge = APG medical insurance payment sum/APG total weight.

Compared with the prior art, the invention has the following beneficial effects:

1. According to the invention, the cost management is carried out aiming at the diagnosis and treatment process of the outpatient, and innovation of the reform of the payment mode of the outpatient medical insurance is helpful for realizing the control of medical cost, the improvement of service quality and the optimization of resource allocation by classifying and grouping diagnosis and treatment projects, packing and pricing and clinic settlement.

2. According to the invention, the outpatient diagnosis and treatment projects are carefully classified by the APG packaging payment method, so that each category can better reflect the actual demands of patients and the cost of medical services.

3. The invention ensures that the expenditure of the outpatient medical insurance fund is in a controllable range through the packaging pricing of the outpatient service, fully considers the flexibility of the outpatient service scheme, and can control the project expense and the total expense in a reasonable interval.

Drawings

Other features, objects and advantages of the present invention will become more apparent upon reading of the detailed description of non-limiting embodiments, given with reference to the accompanying drawings in which:

FIG. 1 is a schematic of the workflow of the present invention.

FIG. 2 is a schematic diagram of an entry group process of an out-patient service according to the present invention.

Fig. 3 is a schematic diagram of a packet packing flow in the present invention.

Fig. 4 is a schematic diagram of a case fee settlement process according to an embodiment of the present invention.

Detailed Description

The present invention will be described in detail with reference to specific examples. The following examples will assist those skilled in the art in further understanding the present invention, but are not intended to limit the invention in any way. It should be noted that variations and modifications could be made by those skilled in the art without departing from the inventive concept. These are all within the scope of the present invention.

According to the invention, as shown in fig. 1, a fee management method based on APG packaging payment receipt grouping comprises the following steps:

Step S1: relevant data of the outpatient is collected. Information about diagnosis, treatment, examination, etc. of the outpatient is collected, and related cost data. The relevant data of the outpatient comprises basic information of the current outpatient and relevant expense data; the basic information includes diagnosis information, treatment information, and examination information.

Step S2: and classifying the relevant data of the outpatient according to the type of the outpatient service, and entering corresponding groups. The groupings in step S2 include a surgical procedure group, an auxiliary service group, and a medical service group. The surgical procedures group includes important surgical procedures for the current patient, the auxiliary service group includes inspection checks for the current patient, and the medical service group includes medical medications for the current patient. As shown in fig. 2, step S2 includes:

Step S2.1: determining whether the related data of the current patient is an important operation, and if so, incorporating the operation group according to the operation or treatment type; if not, step S2.2 is performed.

Step S2.2: judging whether the related data of the current patient is a medical treatment signal, if so, executing the step S2.3; if not, step S2.4 is performed.

Step S2.3: judging whether the related data of the current patient are diagnosis, signs, symptoms and findings, if so, incorporating the related data into a surgical operation group; if not, the medical service group is included according to the main reason of the visit.

Step S3: and packing and pricing the standard expense corresponding to the packet to obtain the corresponding packing service amount. And analyzing historical data of the group standard cost of each outpatient service group, checking standard pricing in a clustering mode, and combining and calculating the group entering cost of the case in one visit to serve as case cost. The step S3 comprises the following steps:

Step S3.1: all cases were put into groups.

Step S3.2: and (5) calculating the cost in the group to obtain the total cost of the corresponding APG disease group.

Step S3.3: and calculating the mechanism grade coefficient, and calculating the average cost of the APG group according to the twice weighting of the patient times and the average cost of the mechanism grade.

Step S3.4: calculating the group weight, dividing the total cost of each APG disease group by the total cost of all APG disease groups to obtain the relative cost of each APG disease group, dividing the relative cost of each APG group by the average cost of all APG disease groups, and further obtaining the weight of each APG disease group.

Step S3.5: and calculating the packing payment price of each disease according to the weight and the mechanism grade coefficient of each APG disease group, wherein the formula is as follows:

Wherein, the group weight is the weight of each APG group, and the mechanism coefficient is the mechanism grade coefficient. The basic fee acquisition steps are as follows:

Step A: obtaining the total payment amount of medical insurance, calculating the total payment amount of APG medical insurance by consulting the total fund budget of the medical insurance annual clinic and the reimbursement proportion of the medical insurance clinic, and the formula is as follows: APG medical insurance payment sum = outpatient overall fund sum budget/medical insurance outpatient reimbursement ratio.

And (B) step (B): and calculating the APG total weight, and acquiring the APG weight of the case through the APG group entering condition of the outpatient throughout the year, thereby obtaining the APG payment total weight.

Step S4: and after the money is processed, the final clinic medical data payment amount is displayed. And displaying the calculated packed payment amount to the medical institution after fully considering the institution coefficient and removing the repeated charge.

Specifically, as shown in fig. 3 and fig. 4, firstly, acquiring medical insurance diagnosis and treatment catalogs, and performing manual one-to-one mapping with the diagnosis and treatment catalogs in the APC grouping scheme; and (3) comparing the unmapped diagnosis and treatment items with a medical service price list to obtain prices, clustering, submitting the prices to clinical examination, and summarizing the clinical examination into diagnosis and treatment items in an APC grouping mode.

Then, according to the inter-group difference of resource consumption, the diagnosis and treatment items are packed to form APG grouping scheme details, and examples are as follows:

Packet type	APG group coding	APG group name	Medical insurance project code	Medical insurance project name
					Surgical operation	0016	Four-stage debridement and destruction	3306080020000	Oral cavity maxillofacial soft tissue debridement (middle)
Surgical operation	0016	Four-stage debridement and destruction	3306080010000	Oral cavity maxillofacial soft tissue debridement (Large)
					Auxiliary service	0343	Grade II pathology	2702000040000	Abscission cytology examination and diagnosis
Auxiliary service	0343	Grade II pathology	2702000010000	Body fluid cytology examination and diagnosis

Then, the fee pricing is performed, and the basic fee of the APG group is calculated according to the weighting of the patient's diagnosis and treatment item, the number of times of use and the price of the diagnosis and treatment service item, and the formula is as follows:

APG group basic fee = diagnosis and treatment item A charging price × person-to-person ratio × average person-to-person + diagnosis and treatment item B charging price × person-to-person ratio × average person-to-person + … …

And then, acquiring the total amount of medical insurance payment, and calculating the APG (advanced personal computing) medical insurance payment total amount by consulting the total amount budget of the fund and the reimbursement proportion of the medical insurance clinic according to the annual medical insurance clinic, wherein the formula is as follows:

Then, calculating the total amount of the clinic overall fund, acquiring the reimbursement amount of diagnosis and treatment items in the APG groups of the cases through the APG group entering condition of the outpatient in the whole year, summarizing the reimbursement amount of the diagnosis and treatment items in each APG group, comparing the reimbursement amount of the diagnosis and treatment items in each APG group with the APG medical insurance payment total amount, taking the APG medical insurance payment total amount as the clinic overall fund total amount if the reimbursement amount of the diagnosis and treatment items in each APG group is larger than the APG medical insurance payment total amount, and taking the reimbursement total amount of the diagnosis and treatment items in each APG group as the clinic overall fund total amount if the reimbursement amount of the diagnosis and treatment items in each APG group is smaller than the APG medical insurance payment total amount;

Next, APG group weights are calculated as follows:

APG group weight = total amount reimbursed for certain APG group diagnosis and treatment project/overall outpatient fund total/patient number of APG group patients

And then calculating the mechanism coefficient of the APG group according to the charging conditions of the APG group diagnosis and treatment project at different mechanism grades, wherein the mechanism coefficient of the APG group is calculated according to the following formula:

APG group institutional grade factor = Σ (institutional grade treatment item A fee ×occupancy rate + institutional grade treatment item B fee ×occupancy rate + … …)/basal fee

Then, calculating the composite adjustment coefficient, and according to the cost proportion conditions of different medical institutions, carrying out conversion, wherein the calculation formula is as follows:

APG group composite adjustment coefficient = different institutional grade APG group case average cost/APG group base cost

And finally, APG packaging payment, and calculating the APG packaging payment total of the hospital according to the following calculation formula.

Further, the implementation flow of the method of the invention is specifically described as follows:

1. making an implementation scheme: hospitals are in charge of establishing special APG packaging payment implementation work groups, and are responsible for formulating implementation modes, definitely implementing targets, principles, ranges, schedules and the like.

2. Preparing a grouping scheme: and a medical care bureau medical service item coding system is adopted to map and check the grouping scheme, so that the charging item codes of the outpatient data can be mapped with the codes one by one. For special service projects of an area or an organization, manual grouping is carried out according to clinical consistency and resource consumption similarity principles, intra-group differences and inter-group differences of grouping schemes are verified, and the requirement of the grouping schemes on statistical rationality is maintained.

3. And (3) extracting out-patient settlement data: extracting all fields in an outpatient settlement main bill and an outpatient settlement detail; checking whether the visit list number of the clinic settlement main list is unique; checking whether all settlement items in the clinic settlement list fill in medical service item codes (15 bits) of medical insurance version; checking whether the price unit of the settlement item in the clinic settlement list is consistent with the medical service item code of the medical insurance version. And establishing a coding mapping relation between the coding version of the settlement item and the coding version in the group entering program, and carrying out data verification and subsequent group entering by using the mapped codes.

4. Case entry group: and (3) carrying out accurate matching on the grouping scheme and the (outpatient settlement item code (medical insurance)) in the settlement details, and returning a grouping result.

5. And (5) fee calculation: judging a primary visit according to the outpatient visit information of the patient, carrying out secondary weighting on the total cost of the case after the case is grouped, giving a main operation, and giving an adjustment coefficient to the grouping result of the auxiliary examination class, wherein the total cost is equal to the sum of the weighted group-entering cost.

6. Pricing and cost adjustment: and according to the diagnosis and treatment service project cost of each disease, determining the packaging payment price of each disease by referring to the charging standard of medical institutions of the same level in the whole city. And is appropriately adjusted according to the relationship between the inside of the visit item and the diagnosis.

7. Fee settlement: and displaying the calculated packed payment amount and the clinic medical data payment amount to a medical institution.

In the specific implementation process, related personnel are required to be trained, and the implementation effect of the grouping scheme is tracked and evaluated, which is as follows:

(1) Training APG packing payment for medical insurance related staff and hospital related medical staff to enable the medical insurance related staff and hospital related medical staff to know and master packing payment principles and methods.

(2) And (3) testing: and selecting part of departments to carry out test point work of APG packing payment, summarizing experience and perfecting an embodiment.

(3) And (3) popularization: APG packaging payment is popularized and implemented in the whole market range, so that the original clinic charging mode is gradually replaced.

(4) And (3) monitoring and evaluating: and establishing an APG packaging payment monitoring and evaluating mechanism, evaluating the implementation effect regularly, and improving the existing problems.

(5) Propaganda and explanation: the benefits of APG packaging payment are advertised to the patient and the public via a variety of channels to explain problems and countermeasures that may occur during implementation.

In the invention, in the grouping design, the APG payment mode is mainly based on clinical operation, and the grouping is formed according to different medical resources and costs consumed by the clinical common characteristics and operation modes of patients from the clinic clinical operation type according to the principle from thick to thin, and the principle of 'similar operation group' is followed. In the payment mode, the APG payment mode takes 'total budget, grouping and packing and point distribution' as a core idea. The total budget determines the total payable funds, controls the expenditure of the medical insurance funds, measures and calculates the points of different diagnosis and treatment service items by a point method, and explores a value-oriented medical service payment mode on the premise of considering the difference of actual medical conditions by adjusting the relative weights and adjustment coefficients of the APG groups. During APG payment operation, firstly, determining grouping types of outpatient service items by adopting an APG grouping technology, then weighting according to relative cost of each item of historical data and considering occurrence times, determining relative weight of an APG group, and performing point distribution by adopting a point method; and finally, reasonably distributing budget funds according to the medical service points. The whole process adopts a mode of 'monthly prepayment and annual final clearing', and in practice, the principle of 'balance remaining and hyperbranched non-replenishment' is followed, so that the fee control power of medical institutions is enhanced, and the efficient operation of medical insurance funds is ensured.

The invention also provides a fee management system based on the APG packed payment receipt grouping, which can be realized by executing the flow steps of the fee management method based on the APG packed payment receipt grouping, namely, a person skilled in the art can understand the fee management method based on the APG packed payment receipt grouping as a preferred implementation mode of the fee management system based on the APG packed payment receipt grouping.

Module M1: relevant data of the outpatient is collected. The relevant data of the outpatient comprises basic information of the current outpatient and relevant expense data; the basic information includes diagnosis information, treatment information, and examination information.

Module M2: and classifying the relevant data of the outpatient according to the type of the outpatient service, and entering corresponding groups. The groupings in module M2 include a surgical procedure group, an auxiliary service group, and a medical service group. The surgical procedures group includes important surgical procedures for the current patient, the auxiliary service group includes inspection checks for the current patient, and the medical service group includes medical medications for the current patient. The module M2 includes: module M2.1: determining whether the related data of the current patient is an important operation, and if so, incorporating the operation group according to the operation or treatment type; if not, the module M2.2 is executed. Module M2.2: judging whether the related data of the current patient is a medical treatment signal, if so, executing a module M2.3; if not, the module M2.4 is executed. Module M2.3: judging whether the related data of the current patient are diagnosis, signs, symptoms and findings, if so, incorporating the related data into a surgical operation group; if not, the medical service group is included according to the main reason of the visit. Module M2.4: judging whether the related data of the current patient is auxiliary examination or operation, if so, incorporating an auxiliary service group according to the detection type; if not, outputting error grouping information.

Module M3: and packing and pricing the standard expense corresponding to the packet to obtain the corresponding packing service amount. The module M3 includes: module M3.1: all cases were put into groups. Module M3.2: and (5) calculating the cost in the group to obtain the total cost of the corresponding APG disease group. Module M3.3: calculating the mechanism grade coefficient, and calculating the average cost of the APG group according to the twice weighting of the patient number and the average cost of the mechanism grade; . Module M3.4: calculating the group weight, dividing the total cost of each APG disease group by the total cost of all APG disease groups to obtain the relative cost of each APG disease group, dividing the relative cost of each APG group by the average cost of all APG disease groups, and further obtaining the weight of each APG disease group. Module M3.5: and calculating the packing payment price of each disease according to the weight and the mechanism grade coefficient of each APG disease group, wherein the formula is as follows: APG package payment sum = Σbase cost group weight establishment coefficient composite adjustment coefficient. Wherein, the group weight is the weight of each APG group, and the mechanism coefficient is the mechanism grade coefficient. The basic fee acquisition module is as follows:

Module a: obtaining the total payment amount of medical insurance, calculating the total payment amount of APG medical insurance by consulting the total fund budget of the medical insurance annual clinic and the reimbursement proportion of the medical insurance clinic, and the formula is as follows: APG medical insurance payment sum = outpatient overall fund sum budget/medical insurance outpatient reimbursement ratio. Module B: and calculating the APG total weight, and acquiring the APG weight of the case through the APG group entering condition of the outpatient throughout the year, thereby obtaining the APG payment total weight. Module C: the basic cost is calculated as follows: basic charge = APG medical insurance payment sum/APG total weight.

Module M4: and after the money is processed, the final clinic medical data payment amount is displayed.

Those skilled in the art will appreciate that the invention provides a system and its individual devices, modules, units, etc. that can be implemented entirely by logic programming of method steps, in addition to being implemented as pure computer readable program code, in the form of logic gates, switches, application specific integrated circuits, programmable logic controllers, embedded microcontrollers, etc. Therefore, the system and various devices, modules and units thereof provided by the invention can be regarded as a hardware component, and the devices, modules and units for realizing various functions included in the system can also be regarded as structures in the hardware component; means, modules, and units for implementing the various functions may also be considered as either software modules for implementing the methods or structures within hardware components.

The foregoing describes specific embodiments of the present application. It is to be understood that the application is not limited to the particular embodiments described above, and that various changes or modifications may be made by those skilled in the art within the scope of the appended claims without affecting the spirit of the application. The embodiments of the application and the features of the embodiments may be combined with each other arbitrarily without conflict.

Claims

1. A fee management method based on APG packaging payment document grouping, comprising:

step S1: collecting relevant data of an outpatient;

2. The APG packaged payment receipt grouping based fee management method of claim 1 wherein the outpatient related data comprises current outpatient base information and related fee data; the basic information includes diagnosis information, treatment information, and examination information;

3. The APG packaged payment document grouping based fee management method of claim 2 wherein step S2 comprises:

4. The APG packaged payment document grouping based fee management method of claim 1 wherein step S3 comprises:

Step S3.1: grouping all cases;

5. The APG packaged payment document grouping based fee management method of claim 4 wherein the base fee acquisition step is as follows:

6. A fee management system for packaging payment documents based on APG, comprising:

Module M1: collecting relevant data of an outpatient;

7. The APG packaged payment receipt grouping based fee management system of claim 6 wherein the outpatient related data comprises current outpatient base information and related fee data; the basic information includes diagnosis information, treatment information, and examination information;

8. The APG packaged payment document grouping based fee management system of claim 7 wherein module M2 comprises:

9. The APG packaged payment document grouping based fee management system of claim 6 wherein module M3 comprises:

Module M3.1: grouping all cases;

10. The APG packaged payment document grouping based fee management system of claim 9 wherein the base fee acquisition module is as follows: