Medical insurance anti-fraud system based on big data excavation
A data mining and big data technology, applied in data processing applications, electrical digital data processing, special data processing applications, etc., can solve problems such as impact
Inactive Publication Date: 2017-09-08
CHENGDU SEFON SOFTWARE CO LTD
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Problems solved by technology
[0004] The purpose of the present invention is to overcome the deficiencies of the prior art, provide a medical insurance anti-fraud system based on big data, and solve the problem that the medical insurance anti-fraud system based on business rules relies heavily on expert knowledge and new medical insurance policies and new fraud strategies. Issues that impact existing systems
Method used
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Embodiment 1
[0080] Such as figure 1 As shown in the medical insurance anti-fraud system based on big data mining, in the actual construction of the system, the ETL subsystem can be composed of Flume and Kafka, and the big data storage subsystem can choose Hbase. By deploying Kafka on various business database servers outside the system , which can extract and convert data in various business databases in real time, and store the processed data in Hbase for use by the data mining subsystem.
[0081] At the initial stage of the system, the contents of the rule base and knowledge base are empty, and the existing rule base in the expert system based on business rules can be imported into the rule base of the system. Data mining in the data storage subsystem. According to whether the data in the big data storage subsystem is marked as fraudulent or normal, it can be divided into two mining methods:
[0082] 1) No labeled samples with fraud features
[0083] Use the Kmeas clustering algorith...
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The invention relates to a medical insurance anti-fraud system based on big data excavation. The system comprises following subsystems including a data extraction, conversion and loading subsystem, a big data storage subsystem, a data excavation subsystem, a rule base and knowledge base subsystem, a real-time flow computing subsystem, and a visualization subsystem, wherein the data extraction, conversion and loading subsystem is connected to the big data storage subsystem; the big data storage subsystem is connected to the data excavation subsystem; the data excavation subsystem is connected to the rule base and knowledge base subsystem; the rule base and knowledge base subsystem is connected to the real-time flow subsystem; and the big data storage subsystem, the rule base and knowledge base subsystem and the real-time flow computing subsystem are then connected to the visualization subsystem. The system provided by the invention has the beneficial effects that more objective rules are established through data excavation; the system can be adapted to service scene changes; a rule base can be established and updated automatically based on data excavation technologies, and external interference is not needed; and more complicated and concealing fraud manners can be recognized.
Description
technical field [0001] The invention relates to the technical field of big data analysis and processing technology, in particular to a medical insurance anti-fraud system based on big data mining. Background technique [0002] According to the 2014 Statistical Bulletin on Human Resources and Social Security Development released by the Ministry of Human Resources and Social Security, the total income of urban basic medical insurance funds in 2014 was 968.7 billion yuan, and the expenditure was 813.4 billion yuan, an increase of 17.4% and 19.6% respectively over the previous year. , although the income is still greater than the expenditure, the income growth rate is significantly lower than the expenditure growth rate, and the medical insurance funds of urban employees in many areas are not covered by the expenditure, and the medical insurance funds are already overwhelmed. revenue growth rate. In addition to the large population base and the aging population, the reasons for...
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Login to View More IPC IPC(8): G06F17/30G06F19/00G06Q40/08
CPCG06Q40/08G06F16/2465G06F16/254
Inventor 赵红军王纯斌覃进学
Owner CHENGDU SEFON SOFTWARE CO LTD