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A method and device for adjusting the compensation amount, an apparatus and a readable storage medium

A technology for adjusting methods and amounts, applied in the field of data processing, can solve problems such as the low accuracy rate of compensation amounts, and achieve the effects of optimizing the review function, improving the accuracy rate, and improving the efficiency of the trial

Pending Publication Date: 2019-04-16
PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0003] The main purpose of the present invention is to provide a compensation amount adjustment method, device, equipment and readable storage medium, aiming to solve the existing technical problems of how to find abnormal data in the claim data and low accuracy rate of compensation amount calculation

Method used

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  • A method and device for adjusting the compensation amount, an apparatus and a readable storage medium
  • A method and device for adjusting the compensation amount, an apparatus and a readable storage medium

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Embodiment Construction

[0039] It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

[0040] The present invention provides a method for adjusting the amount of compensation, referring to figure 1 , figure 1 It is a schematic flowchart of a preferred embodiment of the adjustment method of the compensation amount in the present invention.

[0041] The embodiment of the present invention provides an embodiment of the method for adjusting the amount of compensation. It should be noted that although the logic sequence is shown in the flow chart, in some cases, the sequence shown here can be executed in a different order. or the steps described.

[0042] The adjustment method of the compensation amount is applied in the server or the terminal, and the claim settlement system is set in the terminal and the server, and the terminal can include mobile terminals such as mobile phones, tablet computers, notebo...

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Abstract

The invention discloses a method and device for adjusting the compensation amount, an apparatus and a readable storage medium. The method comprises the following steps: when claim data corresponding to a user is obtained, auditing the claim data is audited according to a preset auditing rule to determine abnormal data in the claim data; Sending the abnormal data to an audit system for the audit system to audit the abnormal data after receiving the abnormal data, and returning the first audit information after the abnormal data is audited; When the first audit information is received, determining invalid data in the abnormal data according to the first audit information, and adjusting an indemnity amount paid to the user according to the invalid data. The invention improves the accuracy ofcalculating the claim amount, improves the processing efficiency of the claim data, and optimizes the checking function of the claim data in the claim processing system.

Description

technical field [0001] The present invention relates to the technical field of data processing, in particular to a compensation amount adjustment method, device, equipment and readable storage medium. Background technique [0002] Today, with the sharp rise in medical expenses, insurance fund revenues are less than expenditures from time to time. Due to bad behaviors such as fraud and abuse, the originally tight insurance funds have not been effectively utilized. When there are abnormal data in the relevant data of medical insurance claims, the compensation amount paid to the user will be inaccurate. From this, it can be seen how to review the relevant data of medical insurance claims, find out the abnormal data, and find the abnormal data. It is extremely important and urgent to adjust the compensation amount of the insurance fund from time to time and improve the accuracy of the calculation of the compensation amount. Contents of the invention [0003] The main purpose...

Claims

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Application Information

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IPC IPC(8): G06Q10/10G06Q40/08
CPCG06Q10/103G06Q40/08
Inventor 罗成洋
Owner PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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