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

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

Active Publication Date: 2020-03-17
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 time limit and low claim precision.

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  • Insurance data review method, device, computer equipment and storage medium
  • Insurance data review method, device, computer equipment and storage medium
  • Insurance data review method, 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 further described in 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 part of the mapping relationship between the disease codes to be reviewed an...

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Abstract

An insurance data checking method and apparatus, a computer device, and a storage medium. The method comprises: receiving an insurance data checking request that carries a disease code to be checked and disease diagnosis data and is sent by a terminal; searching a cached mapping relation table to obtain a standard disease code corresponding to the disease code to be checked from the mapping relation table; searching, when no standard disease code corresponding to the disease code to be checked is obtained from the mapping relation table, a stored mapping database to obtain the standard disease code corresponding to the disease code to be checked; obtaining, when the standard disease code corresponding to the disease code to be checked is obtained, compensation rule data corresponding to a pre-stored standard disease code; and comparing the disease diagnosis data with the compensation rule data to generate a compensation result, and sending the compensation result to the terminal.

Description

technical field [0001] The 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 claim. ...

Claims

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Application Information

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Patent Type & Authority Patents(China)
IPC IPC(8): G06F16/2455G06F16/2457G16H10/00G06Q10/10G06Q40/08
CPCG06F16/24564G06F16/24578G06Q10/103G06Q40/08
Inventor 周运超莫瑞海
Owner PING AN TECH (SHENZHEN) CO LTD
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