To design an inpatient charging management system to optimize the patient accounting flow. The problems in all links were analyzed, and auditing mode and flow were modified. Under the existing HIS, the sys-tem was developed with added datasheets, determined elements, desired rules, .Net framework and C# language. The system made the prescription linked with the charging so that the doubtful items could be marked automatically. The system facilitates the fee auditing, shortens the waiting time of the patient, enhances the communication between the departments and promotes the quality of medical records.