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CN-122023032-A - Policy processing method, device, equipment and medium

CN122023032ACN 122023032 ACN122023032 ACN 122023032ACN-122023032-A

Abstract

The application relates to the technical field of computers and discloses a policy processing method, device, equipment and medium, which comprise the steps of obtaining a co-policy to be processed and original expense data, carrying out structural recombination on the original expense data according to a preset co-policy data map to obtain an expense data set, carrying out characteristic analysis and numerical analysis on expense nodes based on the expense data set through an aggregation analysis model to generate aggregation expense data containing expense direction identifiers and amount weights, carrying out numerical deduction calculation on the aggregation expense data to obtain combined settlement data, extracting settlement characteristic vectors from the combined settlement data through an approval chain generation model to generate an approval node sequence, carrying out approval processing based on the approval node sequence, carrying out payment consistency verification and standing account data matching after approval passes, and outputting payment verification result data. The application can be applied to a financial science and technology or medical care business program system, and can realize the improvement of the accuracy and timeliness of the policy processing flow.

Inventors

  • XIA YI

Assignees

  • 中国平安财产保险股份有限公司

Dates

Publication Date
20260512
Application Date
20260306

Claims (10)

  1. 1. A policy processing method, the method comprising: acquiring a co-insurance policy to be processed and corresponding original expense data, and carrying out structural recombination on the original expense data according to a preset co-insurance data map to obtain an expense data set; Based on the expense data set, carrying out characteristic analysis and numerical analysis on different expense nodes associated with the same policy node through an aggregation analysis model to generate aggregation expense data containing expense direction identification and amount weight, and carrying out numerical deduction calculation on the aggregation expense data to obtain a plurality of combined settlement data; extracting settlement feature vectors from the combined settlement data through an approval chain generation model, and generating corresponding approval node sequences based on the settlement feature vectors; and executing approval processing based on the approval node sequence, executing payment consistency check on the combined settlement data after approval is passed, matching the payment consistency check with the standing account data, and outputting payment check result data.
  2. 2. The method of claim 1, wherein the structuring reorganizing the raw fee data according to a preset co-insurance data schema to obtain a fee data set comprises: Performing format recognition on the original expense data to obtain an initial data set after format recognition; Analyzing the abnormal fields in the initial data set through a large model to obtain an abnormal identification data set; correcting the original expense data according to the abnormal identification data set to obtain a normalized expense data set; And carrying out structural recombination on the normalized expense data set according to the preset co-insurance data map to obtain the expense data set.
  3. 3. The method of claim 1, wherein the generating aggregate cost data including cost direction identification and monetary weight by performing feature analysis and numerical analysis on different cost nodes associated with the same policy node based on the set of cost data by an aggregate analysis model comprises: Grouping the expense data set according to the policy node index to obtain a grouping expense node set; Performing cost type analysis, cost direction judgment and numerical labeling processing on the grouping cost node set through the aggregation analysis model to generate a cost detail node set with positive and negative attribute identifiers; And performing consistency verification and anomaly detection calculation on the intermediate aggregation expense data, and determining the intermediate aggregation expense data passing the verification as the aggregation expense data.
  4. 4. The method of claim 1, wherein performing a numerical deduction calculation on the aggregate cost data results in a plurality of consolidated settlement data, comprising: Performing item-by-item matching and deduction processing on the forward cost and the reverse cost in the aggregated cost data to obtain an initial rolling result data set; performing multi-round iterative computation on the initial rolling stock result data set to obtain combined result data; And carrying out standardized encapsulation on the combined result data to obtain the combined settlement data.
  5. 5. The method of claim 1, wherein the extracting, by an approval chain generation model, a settlement feature vector from the consolidated settlement data, and generating a corresponding approval node sequence based on the settlement feature vector, comprises: Extracting features of the plurality of combined settlement data through the approval chain generation model to obtain settlement feature vectors, wherein the settlement feature vectors comprise an amount scale, a cost composition proportion, a historical settlement record and co-insurance party information; Analyzing the settlement feature data set through the approval chain generation model to obtain an initial approval node candidate set corresponding to each piece of combined settlement data; And carrying out structured encapsulation on the initial approval node candidate set to obtain an approval node sequence corresponding to each combined settlement data.
  6. 6. The method according to claim 1, wherein the performing an approval process based on the approval node series, and performing a payment consistency check and ledger data matching on the combined settlement data after the approval passes, and outputting payment check result data, includes: Triggering corresponding approval nodes step by step according to the approval node sequence to carry out approval processing to obtain an approval state data set, wherein the approval state data set comprises the processing state of each approval node; after the approval state data set represents approval, carrying out payment consistency verification on the combined settlement data to obtain a verified payment data set; and matching and checking the payment data set and the ledger data item by item to obtain the payment verification result data.
  7. 7. The method according to claim 1, wherein the method further comprises: extracting historical tail difference data and amount fluctuation data based on the combined settlement data to obtain a risk characteristic data set; inputting the risk characteristic data set into a prediction model to obtain risk prediction result data; performing association analysis on the risk prediction result data and the approval node sequence to obtain a risk adjustment parameter set; updating the approval node sequence according to the risk adjustment parameter set, and generating the updated approval node sequence.
  8. 8. A policy processing apparatus, comprising: The acquisition module is used for acquiring the co-insurance policy to be processed and the corresponding original expense data, and carrying out structural recombination on the original expense data according to a preset co-insurance data map to obtain an expense data set; The analysis module is used for carrying out characteristic analysis and numerical analysis on different expense nodes associated with the same policy node through an aggregation analysis model based on the expense data set to generate aggregation expense data comprising expense direction identifiers and amount weights, and carrying out numerical deduction calculation on the aggregation expense data to obtain a plurality of combined settlement data; The extraction module is used for extracting settlement feature vectors from the combined settlement data through an approval chain generation model and generating a corresponding approval node sequence based on the settlement feature vectors; And the verification module is used for executing approval processing based on the approval node sequence, executing payment consistency verification on the combined settlement data after approval is passed and matching the combined settlement data with the standing account data, and outputting payment verification result data.
  9. 9. A computer device comprising a memory, a processor and a computer program stored in the memory and executable on the processor, characterized in that the processor implements the steps of the policy processing method according to any of claims 1 to 7 when the computer program is executed.
  10. 10. A computer-readable storage medium storing a computer program, wherein the computer program when executed by a processor implements the steps of the policy processing method according to any one of claims 1 to 7.

Description

Policy processing method, device, equipment and medium Technical Field The present invention relates to the field of computer technologies, and in particular, to a policy processing method, apparatus, device, and medium. Background With the continuous development of financial insurance business, the quantity and the business types of the insurance policy show large-scale and diversified trends, and particularly in the fields of medical insurance, health insurance, endowment insurance and the like, the insurance policy often relates to multi-main participation, multi-expense project settlement and multi-level approval management. The existing policy processing mode is supported by a traditional information system, the functions of the policy processing mode are usually concentrated on policy information input, cost recording and basic approval processing, and the whole flow is mainly driven by manual rules. In the process of cooperatively developing insurance business by a financial institution and a medical health care service institution, the cost type, settlement period and risk factors corresponding to the policy are more complex, and higher requirements are provided for the accuracy, timeliness and compliance of the policy processing flow. However, in the related art, the policy processing flow often has the problems of data dispersion and processing link splitting, different expense items need to be processed respectively, the approval path is difficult to be flexibly adjusted according to the business characteristics, real-time linkage is lacking between the payment verification and the financial account, and the manual burden is easy to be increased in a high-frequency settlement or large-batch policy processing scene. Therefore, a policy processing method that can adapt to the characteristics of finance and medical care business is needed to improve the accuracy and timeliness of the whole processing flow. Disclosure of Invention The invention provides a policy processing method, a policy processing device, policy processing equipment and a policy processing medium, which are used for solving the technical problems of low accuracy, low timeliness and low compliance of a policy processing flow in the related technology. In a first aspect, a policy processing method is provided, where the method includes: acquiring a co-insurance policy to be processed and corresponding original expense data, and carrying out structural recombination on the original expense data according to a preset co-insurance data map to obtain an expense data set; Based on the expense data set, carrying out characteristic analysis and numerical analysis on different expense nodes associated with the same policy node through an aggregation analysis model to generate aggregation expense data containing expense direction identification and amount weight, and carrying out numerical deduction calculation on the aggregation expense data to obtain a plurality of combined settlement data; extracting settlement feature vectors from the combined settlement data through an approval chain generation model, and generating corresponding approval node sequences based on the settlement feature vectors; and executing approval processing based on the approval node sequence, executing payment consistency check on the combined settlement data after approval is passed, matching the payment consistency check with the standing account data, and outputting payment check result data. In a second aspect, there is provided a policy processing apparatus comprising: The acquisition module is used for acquiring the co-insurance policy to be processed and the corresponding original expense data, and carrying out structural recombination on the original expense data according to a preset co-insurance data map to obtain an expense data set; The analysis module is used for carrying out characteristic analysis and numerical analysis on different expense nodes associated with the same policy node through an aggregation analysis model based on the expense data set to generate aggregation expense data comprising expense direction identifiers and amount weights, and carrying out numerical deduction calculation on the aggregation expense data to obtain a plurality of combined settlement data; The extraction module is used for extracting settlement feature vectors from the combined settlement data through an approval chain generation model and generating a corresponding approval node sequence based on the settlement feature vectors; And the verification module is used for executing approval processing based on the approval node sequence, executing payment consistency verification on the combined settlement data after approval is passed and matching the combined settlement data with the standing account data, and outputting payment verification result data. In a third aspect, a computer device is provided, comprising a memory, a processor and a computer program stored in