Multi-class claim automatic auditing method and device, computer equipment and storage medium

Abstract

The invention belongs to the technical field of data processing, and relates to a multi-category claim automatic auditing method and device, computer equipment and a storage medium, and the method comprises the steps: defining auditing entries of different categories of claims; setting an auditing rule and an auditing opinion for each auditing entry; according to the auditing rule and the auditing opinions, automatically auditing the multi-category claims to obtain an automatic auditing result; and performing auditing processing according to the automatic auditing result. Corresponding auditing rules can be freely configured and combined for different claim categories according to claim rules; and the consistency and accuracy of claim auditing can be ensured, the manual auditing cost is reduced, and the operation efficiency is improved.

Description

Technical Field

[0001] The present invention relates to the field of data processing technology, and in particular to a method, device, computer equipment and storage medium for automatic review of multiple categories of claims. Background Art

[0002] If a car breaks down during the warranty period, the manufacturer can file a claim with the manufacturer, who will judge and review the claim. After the dealer submits the warranty claim form to the headquarters, the warranty review specialist at the headquarters will conduct a manual review, relying on personal experience and relevant business knowledge. The dealer will manually query relevant vehicle sales information, vehicle-related warranty and maintenance records, etc., and combine the current manufacturer's claim policy to determine whether the warranty claim form meets the manufacturer's claim standards. This is time-consuming and labor-intensive, with very low review efficiency and low review accuracy. The review standards of each specialist are not uniform, and there are differences in understanding the manufacturer's claim policy. The review knowledge requirements for the reviewers are also high. The review results of different personnel for the same document may be biased, which may easily lead to disputes with dealers. Moreover, as the number of vehicles owned by automobile companies continues to increase, the volume of warranty claims will also increase, and the reserve of warranty reviewers must also be continuously increased to meet the review requirements, conduct timely reviews, and ensure service levels. Summary of the invention

[0003] The purpose of the embodiments of the present invention is to propose a method, device, computer equipment and storage medium for automatic review of multi-category claims to solve the problems in the prior art that vehicle claims are highly dependent on manual labor, claims are time-consuming and labor-intensive, and the review efficiency is low.

[0004] In order to solve the above technical problems, the present invention provides a multi-category claim automatic review method, which adopts the following technical solution, including:

[0005] Define audit items for different categories of claims;

[0006] Setting audit rules and audit opinions for each of the audit items;

[0007] According to the audit rules and the audit opinions, multiple categories of claims are automatically audited to obtain automatic audit results;

[0008] Perform audit processing according to the automatic audit result.

[0009] Preferably, the step of defining audit items for different types of claims specifically includes:

[0010] Clarify the applicable objects of the audit method;

[0011] Define corresponding audit items for each applicable object;

[0012] Configure the corresponding audit opinion for each audit item and store the correspondence between the audit item and the audit opinion.

[0013] Preferably, the step of setting audit rules and audit opinions for each audit item specifically includes:

[0014] Refine the claim categories for each applicable object;

[0015] Audit items are freely configured for each claim category, and the configured audit items are used as an audit rule combination. When the warranty claim form is submitted, it is matched according to the claim category, matched to the corresponding audit item combination, and the document is checked rule by rule.

[0016] Preferably, the step of automatically reviewing multiple categories of claims according to the review rules and the review opinions to obtain the automatic review results specifically includes:

[0017] Configure automatic audit timing tasks, and freely configure the interval time according to different timeliness;

[0018] Start the automatic review task, automatically parse the claim task, save the parsed claim task in the automatic review order library, and conduct polling review.

[0019] Preferably, the step of performing audit processing according to the automatic audit result specifically includes:

[0020] When the automatic review is completed, the review result is automatically determined. If there is a returned claim order, the returned claim order will be automatically sent to the store system;

[0021] If there is a rejected claim order, the rejected claim order will be automatically sent to the store and headquarters system;

[0022] If the automatic review is passed, the claim form will be transferred to the settlement database for settlement.

[0023] Preferably, after the step of automatically reviewing the multiple categories of claims according to the review rules and the review opinions to obtain the automatic review results, the method further includes:

[0024] Claim forms that are rejected or approved by automatic review will be transferred to the headquarters business review database;

[0025] After re-examination of the claim form transferred to the headquarters' business review database, the document status is re-determined, and the review results are automatically generated based on the document status and sent to the store.

[0026] In order to solve the above technical problems, the present invention also provides a multi-category claim automatic review device, which adopts the following technical solution, including:

[0027] Definition module, used to define the audit items for different categories of claims;

[0028] A setting module, used to set audit rules and audit opinions for each of the audit items;

[0029] An automatic audit module, used to automatically audit multiple categories of claims according to the audit rules and the audit opinions, and obtain automatic audit results;

[0030] The audit processing module is used to perform audit processing according to the automatic audit results.

[0031] Preferably, the automatic audit module includes:

[0032] The configuration module is used to configure automatic audit timing tasks, and the interval time can be freely configured according to different timeliness.

[0033] The polling module is used to start the automatic review task, automatically parse the claim task, save the parsed claim task in the automatic review order library, and conduct polling review.

[0034] In order to solve the above technical problems, the present invention also provides a computer device, which adopts the technical solution described below, including a memory and a processor, wherein the memory stores computer-readable instructions, and the processor implements the steps of the above-mentioned multi-category claim automatic review method when executing the computer-readable instructions.

[0035] In order to solve the above technical problems, the present invention also provides a computer-readable storage medium, which adopts the technical solution described below, and stores computer-readable instructions on the computer-readable storage medium. When the computer-readable instructions are executed by the processor, the steps of the above-mentioned multi-category claim automatic review method are implemented.

[0036] Compared with the prior art, the present invention mainly has the following beneficial effects: by first defining audit items for different categories of claims; then setting audit rules and audit opinions for each of the audit items; then automatically auditing multiple categories of claims according to the audit rules and the audit opinions to obtain automatic audit results; finally, audit processing is performed according to the automatic audit results; according to the claim rules, corresponding audit rules can be freely configured and combined for different claim categories; the consistency and accuracy of claim audits can also be ensured, the cost of manual audits can be reduced, and work efficiency can be improved. BRIEF DESCRIPTION OF THE DRAWINGS

[0037] In order to more clearly illustrate the scheme in the present invention, a brief introduction is given below to the drawings required for use in the description of the embodiments of the present invention. Obviously, the drawings described below are some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying any creative work.

[0038] Figure 1 is a flow chart of an embodiment of the multi-category claim automatic review method of the present invention;

[0039] Figure 2 is a flow chart of timed automatic review used in the multi-category claim automatic review method of the present invention;

[0040] Figure 3 It is a schematic diagram of setting audit opinions used in the multi-category claim automatic audit method of the present invention;

[0041] Figure 4 It is a schematic diagram of the maintenance of verification items used in the multi-category claim automatic review method of the present invention;

[0042] Figure 5 It is a schematic diagram of the maintenance of verification rules used in the multi-category claim automatic review method of the present invention;

[0043] Figure 6 It is a detailed schematic diagram of the verification rules used in the multi-category claim automatic review method of the present invention;

[0044] Figure 7 It is a structural schematic diagram of an embodiment of a multi-category claim automatic review device of the present invention;

[0045] Figure 8 It is a schematic structural diagram of an embodiment of a computer device of the present invention. DETAILED DESCRIPTION

[0046] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as those commonly understood by technicians in the technical field of the present invention; the terms used in the specification of the application herein are only for the purpose of describing specific embodiments and are not intended to limit the present invention; the terms "including" and "having" and any variations thereof in the specification and claims of the present invention and the above-mentioned drawings are intended to cover non-exclusive inclusions. The terms "first", "second", etc. in the specification and claims of the present invention or the above-mentioned drawings are used to distinguish different objects, not to describe a specific order.

[0047] Reference to "embodiments" herein means that a particular feature, structure, or characteristic described in conjunction with the embodiments may be included in at least one embodiment of the present invention. The appearance of the phrase in various places in the specification does not necessarily refer to the same embodiment, nor is it an independent or alternative embodiment that is mutually exclusive with other embodiments. It is explicitly and implicitly understood by those skilled in the art that the embodiments described herein may be combined with other embodiments.

[0048] In order to enable those skilled in the art to better understand the solutions of the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings.

[0049] It should be noted that the multi-category claim automatic review method provided in the embodiment of the present invention is generally executed by a server / terminal device, and accordingly, the multi-category claim automatic review device is generally arranged in the server / terminal device.

[0050] It should be understood that the number of terminal devices, networks and servers is merely illustrative and any number of terminal devices, networks and servers may be provided as required.

[0051] Embodiment 1

[0052] Continue to refer Figure 1 , shows a flow chart of an embodiment of the multi-category claim automatic review method of the present invention. The multi-category claim automatic review method comprises the following steps:

[0053] Step S1, defining the audit items for different categories of claims.

[0054] In this embodiment, the electronic device (e.g., server / terminal device) on which the multi-category claim automatic review method runs can receive the multi-category claim automatic review request through a wired connection or a wireless connection. It should be noted that the above wireless connection method may include but is not limited to 3G / 4G / 5G connection, WiFi connection, Bluetooth connection, WiMAXX connection, Zigbee connection, UWB (ultra wideband) connection, and other wireless connection methods currently known or to be developed in the future.

[0055] In this embodiment, step S1 may further include the following steps:

[0056] S11. Clarify the applicable objects of the audit method.

[0057] Applicable objects of the audit method may include new car preparation audit, free maintenance audit, warranty application audit and warranty claim audit, etc., which are stored in the value list in the form of data objects.

[0058] S12. Define corresponding audit items for each applicable object. The audit items depend on the claims policy of the car company. The claims policy of the car company can be loaded one by one, and the claim items can be freely set, mainly setting the relationship between the items and the applicable objects.

[0059] S13. Configure a corresponding audit opinion for each audit item, and store the corresponding relationship between the audit item and the audit opinion.

[0060] Audit comments can include two types, return or rejection. Each type is handled differently. For example, when the document is returned, the document validity status is 1, which means it is valid and can be submitted again. When the document is rejected, the document status is invalid and cannot be submitted again.

[0061] An audit number can be created for the audit entry, and a corresponding relationship between the audit entry and the audit number can be established; the audit number is used as a keyword, and the keyword and the audit entry are stored in pairs in the database.

[0062] Step S2, setting audit rules and audit opinions for each audit item.

[0063] In this embodiment, step S2 may further include the following steps:

[0064] S21. Refine the claim categories for each applicable object.

[0065] Applicable objects include but are not limited to new car preparation review, free maintenance review, warranty application review and warranty claim review, etc. The claim category refinement mainly includes PDI claim, free warranty claim, replacement warranty, accessories warranty, recall, service activities, special cases and other claim categories, and the database stores the applicable objects of each category.

[0066] S22. Freely configure audit items for each claim category, and use the configured audit items as an audit rule combination. When a warranty claim form is submitted, it is matched according to the claim category, matched to the corresponding audit item combination, and the document is checked rule by rule.

[0067] For example, rule verification - query warranty category corresponding rule code implementation:

[0068] map.put("adaptType","3");

[0069] List <Map<String,Object> >checkRuleList=

[0070] seAutoAuditMaintainEvaluationMapper.queryCheckRuleList(map);

[0071] Step S3, automatically auditing multiple categories of claims according to audit rules and audit opinions to obtain automatic audit results.

[0072] In this embodiment, step S3 may further include the following steps:

[0073] S31. Configure automatic audit timing tasks and freely configure the interval time according to different timeliness.

[0074] S32. Start the automatic review task, automatically parse the claim task, save the parsed claim task in the automatic review order library, and perform polling review.

[0075] You can start the automatic review timer service. Each warranty claim form will be automatically reviewed according to the review rules. The automatic review process can be:

[0076] 1) Query the documents in the claim form that have been submitted and are awaiting review.

[0077] 2) The claim forms that meet the audit criteria are placed in the waiting cycle audit pool and prepared for automatic verification.

[0078] 3) Query the audit rules configured in the rule configuration table through the claim category in the document.

[0079] 4) Obtain different audit and verification rule methods through the background database configuration table, cycle through the preset verification rule methods, and audit and verify the claim documents.

[0080] 5) Determine whether the audit rule is configured with an approval number, and it will be automatically passed. If it is set, determine whether there is an approval number in the document. If so, this audit rule will be passed.

[0081] 6) After the rule verification for the warranty claim is performed, F is returned to indicate that the verification failed, and the response reason corresponding to the verification rule is obtained through the rule code.

[0082] 7) After the rule loop verification is completed, if there is a reply reason, it is verified whether business review is required (set through service parameters). If necessary, the document will be transferred to the pending business review status and there is no need for automatic return or rejection based on the processing method in the reply reason category.

[0083] 8) After each warranty claim form is cyclically checked against the rules, it will be automatically approved if there is no reply reason. If there is a reply reason, it will be judged based on the priority of the reply reason processing method: if there is a rejection reply reason, it will be rejected; if there is no rejection and a return, it will be returned; otherwise, it will be approved.

[0084] The corresponding rule code implementation of the loop check can be:

[0085] if(!StringHelper.IsEmptyOrNull(checkRuleList)){

[0086] int i = 0;

[0087] boolean flag = false;

[0088] StringBuilder replyReasonType=new StringBuilder();

[0089] for(Map<String,Object> ruleMap:checkRuleList){

[0090] / / If the confirmation is passed, no verification is required

[0091] if("1".equals(ruleMap.get("isPass"))

[0092] &&! StringHelper.IsEmptyOrNull(map.get("agreeNo"))){

[0093] continue;

[0094] }

[0095] / / Get the rule verification data and find the corresponding method through the rules

[0096] map.put("sql",ruleMap.get("auditSql"));

[0097] Map<String,Object> result=this.checkRule(map);

[0098] if(!StringHelper.IsEmptyOrNull(result)&&

[0099] "F".equals(result.get("action"))){

[0100] result.put("carBrandCode",map.get("carBrandCode"));

[0101] Map<String,Object> reasonMap=

[0102] seAutoAuditMaintainEvaluationMapper.queryReason(result);

[0103] reasonMap.put("guaranteeId",map.get("guaranteeId"));

[0104] reasonMap.put("dlrId",map.get("dlrId"));

[0105] reasonMap.put("autoAuditConditionCode",

[0106] ruleMap.get("autoAuditConditionCode"));

[0107] reasonMap.put("createdDate",this.getNowTime());

[0108] reasonMap.put("lastUpdatedDate",reasonMap.get("createdDate"));

[0109] 9) When returning, check whether the number of returns is greater than the return limit (set by service parameters). If it is greater, reject it.

[0110] 10) When returning, the original document and audit record will be invalidated, and a new return status document and audit record will be regenerated.

[0111] 11) When the final verification and review results of the warranty claim form are rejected or passed, the document review status is updated and the review history is recorded.

[0112] Figure 2 1 is a flow chart of the timed automatic audit used in the multi-category claim automatic audit method of the present invention. Figure 2 As shown, the regular automatic review process includes the following steps:

[0113] S301. Query the documents to be reviewed.

[0114] S302: Determine whether there are any documents to be reviewed, if yes, proceed to step S303.

[0115] S303. Obtain review rules according to claim category.

[0116] S304, determine whether there is an approval number, if yes, go to step S305, otherwise go to step S307.

[0117] S305. Obtain the agreed numbering rules and proceed to step S306.

[0118] S306: Determine whether it is passed, if yes, go to step S310, otherwise go to step S308.

[0119] S307. Obtain review rules according to claim category and proceed to step S308.

[0120] S308. Audit documents according to the circular audit rules.

[0121] S309: Determine whether there is an audit opinion. If yes, proceed to step S311; otherwise, proceed to step S318.

[0122] S310, review passed.

[0123] S311, determine whether manual review is required, if yes, proceed to step S312, otherwise proceed to step S313.

[0124] S312: The document is transferred to the status of awaiting business review.

[0125] S313. Obtain the handling method in the audit opinion.

[0126] S314: Process according to the processing method priority.

[0127] S315: Review and return, proceed to step S316.

[0128] S316: Determine whether the number of returns is exceeded, if yes, proceed to step S320, otherwise proceed to step S317.

[0129] S317: Review rejected, go to step S319.

[0130] S318: If the review is passed, proceed to step S321.

[0131] S319, update the document status to rejected, and go to step S322.

[0132] S320. Update the document status to returned.

[0133] S321. Update the document status to passed.

[0134] S322. Record the audit results and handling methods.

[0135] S323. Record the audit history.

[0136] After the automatic review is completed, the claim form can be directly returned to the dealer for adjustment and processing, or it can be reviewed again by the headquarters business personnel based on the review opinions and then returned to the dealer for corresponding processing.

[0137] Step S4, perform audit processing according to the automatic audit result.

[0138] In this embodiment, step S4 may further include the steps of:

[0139] S41. When the automatic review is completed, the review result is automatically determined. If there is a returned claim order, the returned claim order is automatically sent to the store system.

[0140] The store system can view the audit results and modify the claim form based on the audit opinion information.

[0141] S42. If there is a rejected claim order, the rejected claim order will be automatically sent to the store and headquarters system.

[0142] The store system can no longer be modified and this claim form will be invalidated.

[0143] S43. If the automatic review is passed, the claim form will be transferred to the settlement database for settlement.

[0144] In some optional implementations of this embodiment, after step S3 and before step S4, the electronic device may further perform the following steps:

[0145] P1. Claim forms that are automatically reviewed and determined to be rejected or approved will be transferred to the headquarters business review database.

[0146] If there are other specified requirements, manual review can be carried out again, and the manual review opinions will be added to the claim review record.

[0147] P2. After re-examination of the claim form transferred to the headquarters business review database, the document status is re-determined, and the review results are automatically generated based on the document status and sent to the store.

[0148] After the claim forms transferred to the headquarters business review database are reviewed again, they can be reviewed and confirmed again through automatic review to avoid missing claim review items. The re-review results can then be manually reviewed and appraised by the headquarters warranty claim appraisers.

[0149] Figure 3 Schematic diagram of the audit opinion setting method used in the multi-category claim automatic audit method of the present invention. Figure 3 As shown, set the processing method and processing opinions when the claim form does not meet the review rules.

[0150] When a claim does not meet the review rules, there are two processing methods: return and rejection. In step S4, the corresponding document flow and document validity status will be determined according to different processing methods.

[0151] Figure 4 Schematic diagram of the maintenance of verification items used in the multi-category claim automatic review method of the present invention. Figure 4 As shown, define all audit rules, the scope of objects to which the audit rules apply, and set the audit opinions corresponding to the audit rules.

[0152] Figure 5 Schematic diagram of the maintenance of verification rules used in the multi-category claim automatic review method of the present invention. Figure 5 As shown, audit rules corresponding to various claim categories are set. The rules can be freely selected from the verification item library, i.e., the audit items, and set to take effect.

[0153] Figure 6 Detailed schematic diagram of the verification rules used in the multi-category claim automatic review method of the present invention. Figure 6 As shown, set the audit rules corresponding to various claim categories. The rules can be freely selected from the verification item library and set to take effect. Multiple verification rules can be set, such as spare parts existence verification, vehicle model relationship and per-vehicle usage verification, reason part validity verification, invoice date verification, warranty category validity verification, fault code validity verification, VIN validity verification, warranty vehicle validity verification and reason part warranty guarantee period verification, etc.

[0154] The beneficial effects of implementing this embodiment are as follows: by first defining audit items for different categories of claims; then setting audit rules and audit opinions for each audit item; then automatically auditing multiple categories of claims according to the audit rules and audit opinions to obtain automatic audit results; finally, audit processing is performed based on the automatic audit results; according to the claim rules, corresponding audit rules can be freely configured and combined for different claim categories; it can also ensure the consistency and accuracy of claim audits, reduce manual audit costs, and improve work efficiency.

[0155] The present invention can be used in many general or special computer system environments or configurations. For example: personal computers, server computers, handheld or portable devices, tablet devices, multiprocessor systems, microprocessor-based systems, set-top boxes, programmable consumer electronic devices, network PCs, minicomputers, mainframe computers, distributed computing environments including any of the above systems or devices, etc. The present invention can be described in the general context of computer-executable instructions executed by a computer, such as program modules. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform specific tasks or implement specific abstract data types. The present invention can also be practiced in distributed computing environments, in which tasks are performed by remote processing devices connected through a communication network. In a distributed computing environment, program modules can be located in local and remote computer storage media including storage devices.

[0156] Those skilled in the art can understand that all or part of the processes in the above-mentioned embodiments can be implemented by instructing the relevant hardware through computer-readable instructions, and the computer-readable instructions can be stored in a computer-readable storage medium. When the program is executed, it can include the processes of the embodiments of the above-mentioned methods. Among them, the aforementioned storage medium can be a non-volatile storage medium such as a disk, an optical disk, a read-only memory (ROM), or a random access memory (RAM).

[0157] It should be understood that, although the steps in the flowchart of the accompanying drawings are displayed in sequence as indicated by the arrows, these steps are not necessarily executed in sequence in the order indicated by the arrows. Unless otherwise specified herein, there is no strict order restriction on the execution of these steps, and they can be executed in other orders. Moreover, at least a part of the steps in the flowchart of the accompanying drawings may include multiple sub-steps or multiple stages, and these sub-steps or stages are not necessarily executed at the same time, but can be executed at different times, and their execution order is not necessarily sequential, but can be executed in turn or alternately with other steps or at least a part of the sub-steps or stages of other steps.

[0158] Embodiment 2

[0159] Further references Figure 7 , as a response to the above Figure 1 The present invention provides an embodiment of a multi-category claim automatic review device, and the device embodiment is similar to Figure 1 Corresponding to the method embodiment shown, the device can be specifically applied to various electronic devices.

[0160] like Figure 7 As shown, the multi-category claim automatic review device 50 of this embodiment includes: a definition module 51, a setting module 52, an automatic review module 53 and a review processing module 54. Among them:

[0161] A definition module 51, used to define review items for different categories of claims;

[0162] A setting module 52, used to set audit rules and audit opinions for each audit item;

[0163] The automatic audit module 53 is used to automatically audit multiple categories of claims according to the audit rules and audit opinions to obtain automatic audit results;

[0164] The audit processing module 54 is used to perform audit processing according to the automatic audit results.

[0165] In this embodiment, the definition module 51 further includes: an applicable object module, used to clarify the applicable objects of the audit method; a matching module, used to define corresponding audit items for each applicable object; a corresponding module, used to configure corresponding audit opinions for each audit item, and store the correspondence between the audit items and the audit opinions.

[0166] The setting module 52 further includes: a refinement module, which is used to refine the claim category for each applicable object; an adaptation module, which is used to freely configure audit items for each claim category, and use the configured audit items as an audit rule combination. When the warranty claim form is submitted, it is matched according to the claim category, matched to the corresponding audit item combination, and the document is checked rule by rule.

[0167] The automatic audit module 53 further includes: a configuration module for configuring automatic audit timing tasks, and freely configuring interval time according to different timeliness; a polling module for starting automatic audit tasks, automatically parsing claim tasks, saving the parsed claim tasks in the automatic audit order library, and performing polling audit.

[0168] The audit processing module 54 further includes: an audit completion processing module, which is used to automatically determine the audit result when the automatic audit is completed. If there is a returned claim order, the returned claim order will be automatically sent to the store system; an audit rejection processing module, which is used to automatically send the rejected claim order to the store and headquarters system if there is a rejected claim order; an audit pass processing module, which is used to transfer the claim form to the settlement warehouse for settlement if the automatic audit is determined to be passed.

[0169] The beneficial effects of implementing this embodiment are as follows: by first defining audit items for different categories of claims; then setting audit rules and audit opinions for each audit item; then automatically auditing multiple categories of claims according to the audit rules and audit opinions to obtain automatic audit results; finally, audit processing is performed based on the automatic audit results; according to the claim rules, corresponding audit rules can be freely configured and combined for different claim categories; it can also ensure the consistency and accuracy of claim audits, reduce manual audit costs, and improve work efficiency.

[0170] Embodiment 3

[0171] To solve the above technical problems, the embodiment of the present invention also provides a computer device. Figure 8 , Figure 8 This is a basic structural block diagram of the computer device in this embodiment.

[0172] The above-mentioned computer device 6 includes a memory 61, a processor 62, and a network interface 63 that are interconnected through a system bus. It should be noted that the figure only shows a computer device 6 having components of a memory 61, a processor 62, and a network interface 63, but it should be understood that it is not required to implement all the components shown, and more or fewer components can be implemented instead. Among them, those skilled in the art can understand that the computer device here is a device that can automatically perform numerical calculations and / or information processing according to pre-set or stored instructions, and its hardware includes but is not limited to a microprocessor, an application specific integrated circuit (ASIC), a programmable gate array (FPGA), a digital processor (DSP), an embedded device, etc.

[0173] The computer device may be a desktop computer, a notebook computer, a PDA, a cloud server, etc. The computer device may interact with the user through a keyboard, a mouse, a remote control, a touch pad, or a voice control device.

[0174] The memory 61 includes at least one type of readable storage medium, including flash memory, hard disk, multimedia card, card-type memory (e.g., SD or DX memory, etc.), random access memory (RAM), static random access memory (SRAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), programmable read-only memory (PROM), magnetic memory, disk, optical disk, etc. In some embodiments, the memory 61 may be an internal storage unit of the computer device 6, such as a hard disk or memory of the computer device 6. In other embodiments, the memory 61 may also be an external storage device of the computer device 6, such as a plug-in hard disk, a smart memory card (Smart Media Card, SMC), a secure digital (Secure Digital, SD) card, a flash card (FlashCard), etc. equipped on the computer device 6. Of course, the memory 61 may also include both the internal storage unit of the computer device 6 and its external storage device. In this embodiment, the memory 61 is generally used to store the operating system and various application software installed on the computer device 6, such as computer-readable instructions of the multi-category claim automatic review method, etc. In addition, the memory 61 can also be used to temporarily store various types of data that have been output or are to be output.

[0175] In some embodiments, the processor 62 may be a central processing unit (CPU), a controller, a microcontroller, a microprocessor, or other data processing chips. The processor 62 is generally used to control the overall operation of the computer device 6. In this embodiment, the processor 62 is used to run the computer-readable instructions stored in the memory 61 or process data, such as running the computer-readable instructions of the multi-category claim automatic review method.

[0176] The network interface 63 may include a wireless network interface or a wired network interface. The network interface 63 is generally used to establish a communication connection between the computer device 6 and other electronic devices.

[0177] The beneficial effects of implementing this embodiment are as follows: by first defining audit items for different categories of claims; then setting audit rules and audit opinions for each audit item; then automatically auditing multiple categories of claims according to the audit rules and audit opinions to obtain automatic audit results; finally, audit processing is performed based on the automatic audit results; according to the claim rules, corresponding audit rules can be freely configured and combined for different claim categories; it can also ensure the consistency and accuracy of claim audits, reduce manual audit costs, and improve work efficiency.

[0178] Embodiment 4

[0179] The present invention also provides another embodiment, namely, providing a computer-readable storage medium, which stores computer-readable instructions. The computer-readable instructions can be executed by at least one processor to enable the at least one processor to perform the steps of the automatic review method for multiple categories of claims as described above.

[0180] The beneficial effects of implementing this embodiment are as follows: by first defining audit items for different categories of claims; then setting audit rules and audit opinions for each audit item; then automatically auditing multiple categories of claims according to the audit rules and audit opinions to obtain automatic audit results; finally, audit processing is performed based on the automatic audit results; according to the claim rules, corresponding audit rules can be freely configured and combined for different claim categories; it can also ensure the consistency and accuracy of claim audits, reduce manual audit costs, and improve work efficiency.

[0181] Through the description of the above implementation methods, those skilled in the art can clearly understand that the above-mentioned embodiment methods can be implemented by means of software plus a necessary general hardware platform, and of course can also be implemented by hardware, but in many cases the former is a better implementation method. Based on such an understanding, the technical solution of the present invention is essentially or the part that contributes to the prior art can be embodied in the form of a software product, which is stored in a storage medium (such as ROM / RAM, a magnetic disk, or an optical disk), and includes a number of instructions for a terminal device (which can be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.) to execute the various embodiment methods of the present invention.

[0182] Obviously, the embodiments described above are only some embodiments of the present invention, rather than all embodiments. The preferred embodiments of the present invention are shown in the accompanying drawings, but they do not limit the patent scope of the present invention. The present invention can be implemented in many different forms. On the contrary, the purpose of providing these embodiments is to make the understanding of the disclosure of the present invention more thorough and comprehensive. Although the present invention has been described in detail with reference to the aforementioned embodiments, it is still possible for those skilled in the art to modify the technical solutions described in the aforementioned specific embodiments, or to replace some of the technical features therein with equivalents.

[0183] Any equivalent structure made by using the contents of the specification and drawings of the present invention, directly or indirectly applied in other related technical fields, is also within the scope of protection of the patent of the present invention.

Claims

1. A multi-category claim automatic review method, characterized in that: The steps include: Define audit items for different categories of claims; Setting audit rules and audit opinions for each of the audit items; According to the audit rules and the audit opinions, multiple categories of claims are automatically audited to obtain automatic audit results; Perform audit processing according to the automatic audit result.

2. The multi-category claim automatic review method according to claim 1 is characterized in that: The steps of defining the audit items for different types of claims specifically include: Clarify the applicable objects of the audit method; Define corresponding audit items for each applicable object; Configure the corresponding audit opinion for each audit item and store the correspondence between the audit item and the audit opinion.

3. The multi-category claim automatic review method according to claim 1 is characterized in that: The step of setting audit rules and audit opinions for each audit item specifically includes: Refine the claim categories for each applicable object; Audit items are freely configured for each claim category, and the configured audit items are used as an audit rule combination. When the warranty claim form is submitted, it is matched according to the claim category, matched to the corresponding audit item combination, and the document is checked rule by rule.

4. The multi-category claim automatic review method according to claim 1 is characterized in that: The step of automatically reviewing multiple categories of claims according to the review rules and the review opinions to obtain the automatic review results specifically includes: Configure automatic audit timing tasks, and freely configure the interval time according to different timeliness; Start the automatic review task, automatically parse the claim task, save the parsed claim task in the automatic review order library, and conduct polling review.

5. The multi-category claim automatic review method according to claim 1 is characterized in that: The step of performing audit processing according to the automatic audit result specifically includes: When the automatic review is completed, the review result is automatically determined. If there is a returned claim order, the returned claim order will be automatically sent to the store system; If there is a rejected claim order, the rejected claim order will be automatically sent to the store and headquarters system; If the automatic review is passed, the claim form will be transferred to the settlement database for settlement.

6. The multi-category claim automatic review method according to any one of claims 1 to 5, characterized in that: After the step of automatically reviewing the multiple categories of claims according to the review rules and the review opinions to obtain the automatic review results, the following step is further included: Claim forms that are rejected or approved by automatic review will be transferred to the headquarters business review database; After re-examination of the claim form transferred to the headquarters' business review database, the document status is re-determined, and the review results are automatically generated based on the document status and sent to the store.

7. A multi-category claim automatic review device, characterized in that: include: Definition module, used to define the audit items for different categories of claims; A setting module, used to set audit rules and audit opinions for each of the audit items; An automatic audit module, used to automatically audit multiple categories of claims according to the audit rules and the audit opinions, and obtain automatic audit results; The audit processing module is used to perform audit processing according to the automatic audit results.

8. The multi-category claim automatic review device according to claim 7, characterized in that: The automatic audit module includes: The configuration module is used to configure automatic audit timing tasks, and the interval time can be freely configured according to different timeliness. The polling module is used to start the automatic review task, automatically parse the claim task, save the parsed claim task in the automatic review order library, and conduct polling review.

9. A computer device, comprising a memory and a processor, wherein the memory stores computer-readable instructions, and when the processor executes the computer-readable instructions, the steps of the multi-category claim automatic review method as described in any one of claims 1 to 6 are implemented.

10. A computer-readable storage medium, characterized in that: The computer-readable storage medium stores computer-readable instructions, which, when executed by a processor, implement the steps of the multi-category claim automatic review method as described in any one of claims 1 to 6.

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