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Insurance data checking method and device, computer equipment and storage medium

A data and database technology, applied in the computer field, can solve the problems of low claim settlement accuracy, low claim settlement efficiency, and long claim settlement time.

Active Publication Date: 2018-02-23
PING AN TECH (SHENZHEN) CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0003] Based on this, it is necessary to provide an insurance data review method, device, computer equipment and storage medium for the technical problems of low efficiency of traditional medical insurance claim review, long claim timeliness and low claim precision.

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  • Insurance data checking method and device, computer equipment and storage medium
  • Insurance data checking method and device, computer equipment and storage medium
  • Insurance data checking method and device, computer equipment and storage medium

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Embodiment Construction

[0046]In order to make the object, technical solution and advantages of the present invention clearer, the present invention will be described in further detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

[0047] The insurance data verification method provided in the embodiment of the present invention can be applied to such as figure 1 shown in the application environment. A plurality of terminals 102 are connected to a server 104 via a network. The terminal 102 may be a smart device capable of running various applications, such as a computer, a notebook computer, a tablet computer, or a smart phone. The server 104 caches the mapping relationship table and stores the mapping database. The mapping relationship table records the partial mapping relationship between the disease coding to be reviewed a...

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Abstract

The invention relates to an insurance data checking method and device, a piece of computer equipment and a storage medium, wherein the method includes the following steps: receiving a request sent bya terminal to check the insurance data with a disease coding to be checked and disease checking data; searching for a cached mapping relation table, and obtaining a standard disease coding corresponding to the disease coding to be checked from the mapping relation table; when the standard disease coding corresponding to the disease coding to be checked is not obtained from the mapping relation table, searching for the stored mapping database to obtain the standard disease coding corresponding to the disease coding to be checked; when the standard disease coding corresponding to the disease coding to be checked is obtained, obtaining compensation rule data corresponding to the pre-stored standard disease coding; comparing disease diagnostic data with the compensation rule data to generate compensation results, and sending the compensation results to the terminal. The insurance data checking method has the advantages of high efficiency of claim auditing and high precision of claim auditing.

Description

technical field [0001] The present invention relates to the field of computer technology, in particular to an insurance data review method and device, computer equipment and a storage medium. Background technique [0002] With the development of the insurance industry, insurance companies have increasingly frequent business contacts with hospitals and local social security bureaus. Hospitals or local social security bureaus provide data to insurance companies for professional medical insurance claim review to improve the accuracy of medical insurance claim review. Generally, traditional insurance companies use manual auditing methods for medical insurance claims auditing of data from hospitals or local social security bureaus. First, the insurance company regularly assigns staff to the hospitals or social security bureaus to collect medical claims data for a period of time, and then the auditors Review the complex and diverse data collected to determine whether to settle the...

Claims

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Application Information

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IPC IPC(8): G06F17/30G16H10/00G06Q10/10G06Q40/08
CPCG06F16/24564G06F16/24578G06Q10/103G06Q40/08
Inventor 周运超莫瑞海
Owner PING AN TECH (SHENZHEN) CO LTD
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