CN113792570A

CN113792570A - Claims data processing method and device, electronic equipment and readable medium

Info

Publication number: CN113792570A
Application number: CN202011377700.4A
Authority: CN
Inventors: 刘辉
Original assignee: Jingdong Allianz Property Insurance Co ltd
Current assignee: Jingdong Allianz Property Insurance Co ltd
Priority date: 2020-11-30
Filing date: 2020-11-30
Publication date: 2021-12-14

Abstract

The embodiment of the disclosure provides a method and a device for processing claim data, electronic equipment and a readable medium, wherein the method comprises the following steps: acquiring a claim settlement request, wherein the claim settlement request comprises an image to be identified; desensitizing the image to be identified to obtain a desensitized image requested by claim settlement; calling an external interface to send the desensitization image of the claim settlement request, and obtaining character recognition information returned by the external interface; and generating a claim settlement result of the claim settlement request by using the character recognition information. The claim data processing method and device, the electronic device and the readable medium provided by the embodiment of the disclosure can remove the privacy information in the image to be identified through desensitization processing, and further avoid the disclosure of the privacy information when an external interface is called to perform character identification on the desensitized image.

Description

Claims data processing method and device, electronic equipment and readable medium

Technical Field

The present disclosure relates to the field of intelligent claims settlement technology, and in particular, to a method and an apparatus for processing claim data, an electronic device, and a computer-readable medium.

Background

Currently, in the process of realizing automatic claim settlement, electronic documents uploaded by users need to be processed. The electronic document is a picture form of a paper document. Paper documents may include, but are not limited to, identification cards, bank cards, invoices, medical records, copies of diagnostic certificates, and the like. Due to the characteristics of various and complicated claim settlement documents, various claim settlement documents are mainly checked by the claims settling staff manually and visually, confirmed text contents are converted into claim settlement data, the claim settlement data are manually and manually entered into the claim settlement system, a large amount of manpower and material resources are consumed, and both manual identification and manual entry can have large errors. In order to save manpower and material resources and improve the accuracy of document identification, an external figure identification provider is adopted to carry out intelligent identification on the electronic documents. However, insurance enterprises need to protect the privacy of clients due to compliance and other factors, and cannot allow non-claims related personnel to process related image data. This presents an obstacle for external pattern recognition providers to handle.

Therefore, a new method, device, electronic device and computer readable medium for processing claim data are needed.

The above information disclosed in this background section is only for enhancement of understanding of the background of the disclosure and therefore it may contain information that does not constitute prior art that is already known to a person of ordinary skill in the art.

Disclosure of Invention

In view of this, embodiments of the present disclosure provide a method and an apparatus for processing claim data, an electronic device, and a computer-readable medium, which can improve accuracy of electronic document identification in an automated claim settlement process on the premise of ensuring privacy of a client.

Additional features and advantages of the disclosure will be set forth in the detailed description which follows, or in part will be obvious from the description, or may be learned by practice of the disclosure.

According to a first aspect of the embodiments of the present disclosure, a method for processing claims data is provided, the method including: acquiring a claim settlement request, wherein the claim settlement request comprises an image to be identified; desensitizing the image to be identified to obtain a desensitized image requested by claim settlement; calling an external interface to send the desensitization image of the claim settlement request, and obtaining character recognition information returned by the external interface; and generating a claim settlement result of the claim settlement request by using the character recognition information.

In an exemplary embodiment of the present disclosure, performing desensitization processing on the image to be identified, obtaining a desensitized image includes: zooming the image to be identified according to a preset size to obtain a zoomed image; determining an image category of the scaled image; determining a desensitization region of the scaled image according to the image category; and carrying out desensitization processing on the desensitization area of the scaled image to obtain the desensitization image.

In an exemplary embodiment of the present disclosure, determining the image category of the zoom image includes: acquiring an image training set, wherein the image training set comprises sample images and classification labels of the sample images; processing the sample image by using a machine learning model to obtain a prediction result; determining a loss function according to the prediction result and the classification label of the sample image; adjusting the machine learning model by using the loss function to obtain the trained machine learning model; and processing the zoomed image according to the trained machine learning model to obtain the image classification of the zoomed image.

In an exemplary embodiment of the disclosure, invoking an external interface to send a desensitization image of the claim settlement request, and obtaining text recognition information returned by the external interface includes: marking the desensitized image of the claim request according to the claim identification of the claim request; sending the marked desensitized image to the external interface; and receiving the text recognition information returned by the external interface according to the claim settlement identification of the claim settlement request.

In an exemplary embodiment of the disclosure, generating the claim result of the claim request using the text recognition information includes: carrying out structuring processing on the character recognition information to obtain structured data, wherein the structured data comprises bill information and medicine information; verifying the bill information to obtain a verification result; searching for the repeated bill according to the bill identification in the bill information in the historical case information; and when the verification result is that the verification result is passed and the repeated bill is found to be failed, generating a claim settlement result of the claim settlement request according to the bill information and the medicine information.

In an exemplary embodiment of the disclosure, generating a claim settlement result of the claim settlement request according to the ticket information and the drug information includes: determining the medicine category and the claim settlement proportion of the medicine information according to the medicine library data; matching medical record data in the bill information with the risk information and the disease information of the claim settlement request to obtain a matching result; and when the matching result is passed, calculating and obtaining a claim settlement result of the claim settlement request according to the medicine category and the claim settlement proportion of the medicine information and the bill information.

In an exemplary embodiment of the disclosure, generating a claim settlement result of the claim settlement request using the text recognition information further comprises: when the repeated bill is found successfully, the target bill corresponding to the repeated bill and the target historical claims of the repeated bill in the historical case information are obtained; adjusting the target bill information according to the historical claim settlement result of the target historical claim to obtain adjusted bill information; and generating the claim settlement result of the claim settlement request according to the adjustment bill information and the medicine information.

According to a second aspect of the embodiments of the present disclosure, there is provided a claim data processing apparatus, the apparatus including: the request acquisition module is configured to acquire a claim settlement request, and the claim settlement request comprises an image to be identified; a desensitization processing module configured to perform desensitization processing on the image to be identified to obtain a desensitization image of the claim settlement request; the character recognition module is configured to call an external interface to send the desensitization image of the claim settlement request, and obtain character recognition information returned by the external interface; and the claim settlement processing module is configured to generate a claim settlement result of the claim settlement request by using the text recognition information.

According to a third aspect of the embodiments of the present disclosure, an electronic device is provided, which includes: one or more processors; storage means for storing one or more programs; when the one or more programs are executed by the one or more processors, the one or more processors are caused to implement the claims data processing method of any of the above.

According to a fourth aspect of the embodiments of the present disclosure, a computer-readable medium is proposed, on which a computer program is stored, which when executed by a processor, implements the claim data processing method according to any one of the above.

According to the claim data processing method, the claim data processing device, the electronic equipment and the computer readable medium, desensitization processing is performed on the image to be identified of the claim request, then the external interface is called to perform character identification on the desensitization image, privacy information in the image to be identified can be removed through the desensitization processing, and therefore the privacy information is prevented from being leaked when the external interface is called to perform character identification on the desensitization image. Meanwhile, character recognition is carried out on the desensitization image based on an external interface, manpower and material resources can be saved, and accuracy of document recognition is improved.

It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the disclosure.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the present disclosure and together with the description, serve to explain the principles of the disclosure. The drawings described below are merely some embodiments of the present disclosure, and other drawings may be derived from those drawings by those of ordinary skill in the art without inventive effort.

Fig. 1 is a system block diagram illustrating a method and apparatus for claim data processing according to an example embodiment.

FIG. 2 is a flow diagram illustrating a method of claim data processing, according to an example embodiment.

FIG. 3 is a flow diagram illustrating a method of claim data processing, according to an example embodiment.

FIG. 4 is a flow diagram illustrating a method of claim data processing, according to an example embodiment.

Fig. 5 is a flowchart illustrating a method of claim data processing according to another example embodiment.

Fig. 6 is a diagram illustrating a presentation of a text recognition result according to an example embodiment.

Fig. 7 is a presentation diagram illustrating drug information according to an example embodiment.

Fig. 8 is a block diagram illustrating a claims data processing apparatus according to an example embodiment.

Fig. 9 schematically illustrates a block diagram of an electronic device in an exemplary embodiment of the disclosure.

Detailed Description

Example embodiments will now be described more fully with reference to the accompanying drawings. Example embodiments may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of example embodiments to those skilled in the art. The same reference numerals denote the same or similar parts in the drawings, and thus, a repetitive description thereof will be omitted.

The described features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. In the following description, numerous specific details are provided to provide a thorough understanding of embodiments of the invention. One skilled in the relevant art will recognize, however, that the invention may be practiced without one or more of the specific details, or with other methods, components, devices, steps, and so forth. In other instances, well-known methods, devices, implementations or operations have not been shown or described in detail to avoid obscuring aspects of the invention.

The drawings are merely schematic illustrations of the present invention, in which the same reference numerals denote the same or similar parts, and thus, a repetitive description thereof will be omitted. Some of the block diagrams shown in the figures do not necessarily correspond to physically or logically separate entities. These functional entities may be implemented in the form of software, or in one or more hardware modules or integrated circuits, or in different networks and/or processor devices and/or microcontroller devices.

The flow charts shown in the drawings are merely illustrative and do not necessarily include all of the contents and steps, nor do they necessarily have to be performed in the order described. For example, some steps may be decomposed, and some steps may be combined or partially combined, so that the actual execution sequence may be changed according to the actual situation.

The following detailed description of exemplary embodiments of the invention refers to the accompanying drawings.

The server 105 may be a server that provides various services, such as a back-office management server (by way of example only) that provides support for claims data processing systems operated by users with the

terminal devices

101, 102, 103. The background management server may analyze and perform other processing on the received claims data processing request and other data, and feed back a processing result (for example, a claim result — just an example) to the terminal device.

The server 105 may, for example, obtain a claim settlement request, the claim settlement request including an image to be identified; the server 105 may, for example, perform desensitization processing on the image to be identified, and obtain a desensitized image requested by the claim settlement; the server 105 may, for example, call the external interface to send a desensitization image of the claim request, and obtain the text recognition information returned by the external interface. The server 105 can generate a claim result of the claim request, for example, using the textual recognition information.

The server 105 may be a server of one entity, and may also be composed of a plurality of servers, for example, a part of the server 105 may be, for example, used as a claim data processing task submitting system in the present disclosure, and is used to obtain a task to execute a claim data processing command; and a portion of the server 105 may also be used, for example, as a claim data processing system in the present disclosure, to obtain a claim request that includes an image to be identified; desensitizing the image to be identified to obtain a desensitized image requested by claim settlement; calling an external interface to send the desensitization image of the claim settlement request, and obtaining character recognition information returned by the external interface; and generating a claim settlement result of the claim settlement request by using the character recognition information.

According to the claim data processing method and device provided by the embodiment of the disclosure, technical effects can be achieved.

FIG. 2 is a flow diagram illustrating a method of claim data processing, according to an example embodiment. The claims data processing method provided by the embodiments of the present disclosure may be executed by any electronic device with computing processing capability, for example, the

terminal devices

101, 102, and 103 and/or the server 105, and in the following embodiments, the server executes the method as an example for illustration, but the present disclosure is not limited thereto. The claim data processing method 20 provided by the embodiment of the present disclosure may include steps S202 to S208.

As shown in fig. 2, in step S202, a claim settlement request is obtained, the claim settlement request including an image to be recognized.

In the embodiment of the disclosure, the image to be recognized may be a scanned image, a shot image, or the like of a paper document uploaded by an initiator of a claim settlement request (e.g., an insurance user) through a terminal. Wherein the paper document can be, for example but not limited to, as

In step S204, desensitization processing is performed on the image to be identified, and a desensitization image requested by claim is obtained.

In the embodiment of the disclosure, desensitization processing may be performed on a predetermined region of an image to be identified, so as to obtain a desensitization image requested by claim settlement. Among them, the desensitization treatment may be: the pixels of the specified area (i.e., the foregoing predetermined area) are replaced with the specified pixels. The specified pixels may be, for example, but not limited to, blank pixels, pixels of a mosaic color patch, and the like.

In step S206, the external interface is called to send the desensitized image of the claim settlement request, and the text recognition information returned by the external interface is obtained.

In the embodiment of the present disclosure, the external interface may be a service interface of a graphics recognition provider, and the external interface may process the desensitized image by using Optical Character Recognition (OCR), obtain character recognition information of the desensitized image, and return the character recognition information. The character recognition information is text format data obtained after the external interface carries out character recognition according to the desensitization image.

In step S208, the claim settlement result of the claim settlement request is generated using the character recognition information.

In the embodiment of the disclosure, semantic analysis can be performed on the text recognition information, structured data is extracted and obtained, and a claim settlement result of the claim settlement request is generated according to the structured data and the claim settlement rule. When the images to be recognized in the claim settlement request are all recognized successfully to obtain the text recognition information, the recognition results can be as shown in fig. 6. Step S208 of the present embodiment is executed when there is no desensitized image whose identification has failed in the claim request.

According to the claim data processing method provided by the embodiment of the disclosure, after desensitization processing is performed on the image to be identified of the claim request, the external interface is called to perform character identification on the desensitized image, and privacy information in the image to be identified can be removed through the desensitization processing, so that the privacy information is prevented from being leaked when the external interface is called to perform character identification on the desensitized image. Meanwhile, character recognition is carried out on the desensitization image based on an external interface, manpower and material resources can be saved, and accuracy of document recognition is improved.

In an exemplary embodiment, in step S206, a request for desensitization of a claim request can be flagged according to the claim identification of the claim request; sending the marked desensitized image to an external interface; and receiving the text recognition information returned by the external interface according to the claim identification of the claim request. The claim identification is a unique identification for distinguishing the claim request from other claim requests. The desensitization image is marked through the claim identification, and when the text recognition information returned by the external interface is received, the text recognition information corresponding to the claim request can be recognized according to the marked claim identification. When a lot of claim settlement requests are faced, the lot of images to be recognized can be processed in a non-error mode.

FIG. 3 is a flow diagram illustrating a method of claim data processing, according to an example embodiment. As shown in fig. 3, when performing desensitization processing on an image to be recognized to obtain a desensitized image, the method for processing claim data provided by the embodiment of the present disclosure may include steps S302 to S308.

In step S302, the image to be recognized is zoomed according to a preset size, so as to obtain a zoomed image.

In the embodiment of the present disclosure, the preset size may be a designated scaling size of the image to be recognized.

In step S304, the image category of the zoom image is determined.

In embodiments of the present disclosure, image categories may be matched for each image to be identified, for example, at the time of issuance of a claim request; the image to be recognized can be processed by utilizing the machine learning model, and the image category of the image to be recognized is obtained. Image categories may include, but are not limited to, identification card images, bank card images, medical record images, invoice images, itinerary images, delay certification images, drug list images, and the like.

In an exemplary embodiment, an image training set may be obtained, the image training set including sample images and class labels for the sample images; processing the sample image by using a machine learning model to obtain a prediction result; determining a loss function according to the prediction result and the classification label of the sample image; adjusting the machine learning model by using the loss function to obtain a trained machine learning model; and processing the zoomed images according to the trained machine learning model to obtain image classification of the zoomed images.

Wherein a machine learning model may be set for each image class. The training set of images for each machine learning model may include positive and negative sample images. For example, for a machine learning model whose image class is identification card images, its image training set may include positive sample images that are identification card images and negative sample images that are non-identification card images. The classification label of the positive sample image may be 1, for example, and the classification label of the negative sample image may be 0, for example.

In step S306, a desensitization region of the image to be identified is determined according to the image category.

In the embodiment of the disclosure, for the images to be recognized of the same image category, the position of the privacy information in the images is usually a fixed position. For an identity card image, when the private information includes a name and a year and month of birth, an area of the name and the year and month of birth in the identity card image at a predetermined size may be determined as an image category that is a desensitized area of the identity card image.

In step S308, desensitization processing is performed on the desensitization region of the image to be recognized, and a desensitization image is obtained.

According to the claim data processing method provided by the embodiment of the disclosure, the image to be recognized is zoomed, the desensitization area is determined according to the image type, and then desensitization processing is performed in the desensitization area, so that the privacy information in the image to be recognized can be removed, and further the privacy information is prevented from being leaked when an external interface is called to perform character recognition on the desensitization image.

According to the claim data processing method provided by the embodiment of the disclosure, the trained machine learning model is obtained according to the image training set, the zoomed images can be processed by using the trained machine learning model, the zoomed images are accurately classified, and the image categories of the zoomed images are obtained, so that accurate desensitization is performed on the image parts with the privacy areas in the following process.

In an exemplary embodiment, the image to be identified and the desensitized image may also be stored; when a viewing request for claim results is received, the image to be identified and the desensitized image are sent.

FIG. 4 is a flow diagram illustrating a method of claim data processing, according to an example embodiment. As shown in fig. 4, when generating a claim result of a claim request by using the text recognition information, the method for processing claim data provided by the embodiment of the disclosure may include steps S402 to S408.

In step S402, the character recognition information is structured to obtain structured data, where the structured data includes the bill information and the medicine information.

In the disclosed embodiment, the structured data can be input into a claim settlement system, so that verification, check and settlement can be performed by the claim settlement system according to claim settlement rules. Wherein, each image to be identified can have its corresponding ticket information. Each image to be identified may also have its corresponding drug information. The ticket information may include, but is not limited to, information identifying the ticket (e.g., invoice number of the invoice), the amount of the ticket (e.g., invoice amount of the invoice), the date of generation (e.g., invoice date of invoicing) issuing institution, the hospital at issue, etc.

In step S404, the ticket information is verified to obtain a verification result.

In the embodiment of the disclosure, the bill information corresponding to the image to be identified of the specified category can be verified. The specified categories can be, for example, invoices, medical records, and the like. For example, for the invoice category, the verification can be, for example, the invoice date and the insurance date, the issuing institution and the insurance hospital, and the invoice amount of the invoice are verified to verify the validity.

In step S406, a repeated ticket is obtained by searching in the history case information according to the ticket identifier in the ticket information.

In the embodiment of the disclosure, the bill identification in the bill information is the unique identification of the bill information. When the image to be identified included in the current claim settlement request is paid in the historical case, the repeated bill information, namely the repeated bill, is stored in the historical case.

In step S408, when the verification result is pass and the finding fails to obtain the repeated ticket, a claim settlement result of the claim settlement request is generated according to the ticket information and the medicine information.

In the embodiment of the disclosure, the bill information is verified to verify the authenticity of the bill information. Repeated bills are searched in the historical case information in a gathering mode, so that repeated processing and claim case repetition of the repeated bills used in the historical cases can be avoided.

In an exemplary embodiment, when a claim settlement result of the claim settlement request is generated according to the ticket information and the drug information, a drug category and a claim settlement ratio of the drug information may be determined according to the drug library data; matching medical record data in the bill information with the risk information and the disease information of the claim settlement request to obtain a matching result; and when the matching result is passed, calculating to obtain the claim settlement result of the claim settlement request according to the medicine category and the claim settlement proportion of the medicine information and the bill information.

In which, a third-party drug library (i.e. drug library data) may be called to determine the drug fee that can be settled in the drug information, the type of the drug (e.g. class a, class b, class c), the reimbursement rate, the self-payment rate, whether the drug is self-paid, etc., as shown in fig. 7. And judging whether the medicine information is data belonging to the claim settlement category or not by combining insurance terms corresponding to the claim settlement request. And comparing whether the medical record data is matched with the risk information and the disease information.

In an exemplary embodiment, when the repeated bills are found successfully, the target bills corresponding to the repeated bills and the target historical claims of the repeated bills in the historical case information can be obtained; adjusting the target bill information according to the historical claim settlement result of the target historical claim to obtain adjusted bill information; and generating a claim settlement result of the claim settlement request according to the adjustment bill information and the medicine information. In the target historical claims, the repeated bill may be partially paid. For example, if a medicine is paid for a part of the amount in the target historical claim, but a part of the amount is not paid, the amount paid for the current claim is adjusted according to the amount paid for the historical claim, and the adjustment bill information is obtained. The embodiment can realize complete claim payment of the claim settlement request, and avoid failure in screening out the claim payment caused by incomplete claim payment.

It should be clearly understood that this disclosure describes how to make and use particular examples, but the principles of this disclosure are not limited to any details of these examples. Rather, these principles can be applied to many other embodiments based on the teachings of the present disclosure.

Fig. 5 is a flowchart illustrating a method of claim data processing according to another example embodiment. The claim data processing method 50 includes at least steps S502 to S506. Therein, the desensitization system 520 and the entire identification processing system are deployed in a corporate intranet environment, isolated from the outside network environment.

As shown in fig. 5, in step S502, a call request of the desensitization system to the picture query interface is received, and a picture link (i.e., a picture link of an image to be recognized) is returned.

In step S504, when all desensitization of the desensitization system fails, a call request to the desensitization failed picture callback interface is received, and a desensitization failed picture is received.

In step S506, the image to be recognized and the desensitized image are stored.

After the desensitization image is identified to obtain the identification character information, the desensitization image can be transmitted back to the claim settlement system, and the claim settlement system determines a claim settlement result according to an settlement rule.

In this embodiment, case data is provided from a business scenario and machine learning trains the recognition model. The claim settlement system provides identification drawing information through interface batch or claim case according to business requirements. The graphic data is provided with key personal information which is coded and desensitized, so that the information provided by the graphic content becomes irrelevant to the individual and can be only relevant to the individual according to the claim in the claim settlement system. And after the optical characters are identified, the content information is acquired through the interface to obtain the graphic image information needing to be identified. The calling interface returns graphic identification information, which is mainly invoice and medicine information, and also has information of an identification card bank card. The claim settlement system integrates the claim settlement information according to the identified bill information, and assists business personnel to settle claims.

The rational rule may be, for example, as follows.

The method is characterized in that rules are added to automatically settle the batch of specific cases on the premise of being integrated with the existing claim settlement system, so that the service burden is reduced. In the embodiment, data identification and integration of a claim settlement system can be realized, and innovative design of automation of partial or full processes of claim settlement is realized. The method is characterized in that a large amount of paper and graphic document data received every day are identified and converted into standard electronic data information records, and the standard electronic data information records are processed according to a certain rule and then integrated into the existing business system. The system supports daily claim processing, assists a user in identifying data, adjusting and inputting and calculating, and also provides powerful data guarantee for future claim processing and anti-claim fraud.

Those skilled in the art will appreciate that all or part of the steps for implementing the above embodiments are implemented as a computer program executed by a Central Processing Unit (CPU). When executed by a central processing unit CPU, performs the above-described functions defined by the above-described methods provided by the present disclosure. The program may be stored in a computer readable storage medium, which may be a read-only memory, a magnetic or optical disk, or the like.

Furthermore, it should be noted that the above-mentioned figures are only schematic illustrations of the processes involved in the methods according to exemplary embodiments of the present disclosure, and are not intended to be limiting. It will be readily understood that the processes shown in the above figures are not intended to indicate or limit the chronological order of the processes. In addition, it is also readily understood that these processes may be performed synchronously or asynchronously, e.g., in multiple modules.

The following are embodiments of the disclosed apparatus that may be used to perform embodiments of the disclosed methods. For details not disclosed in the embodiments of the apparatus of the present disclosure, refer to the embodiments of the method of the present disclosure.

Fig. 8 is a block diagram illustrating a claims data processing apparatus according to an example embodiment. Referring to fig. 8, the claim data processing apparatus 80 provided in the embodiment of the present disclosure may include: a request acquisition module 802, a desensitization processing module 804, a word recognition module 806, and a claims processing module 808.

In the claim data processing apparatus 80, the request acquisition module 802 can be configured to acquire a claim request that includes an image to be identified.

The desensitization processing module 804 can be configured to perform desensitization processing on the image to be identified to obtain a desensitization image of the claim request.

The text recognition module 806 can be configured to invoke an external interface to send a desensitized image of the claim request, obtaining text recognition information returned by the external interface.

The claim processing module 808 can be configured to generate a claim result of the claim request using the textual identification information.

According to the claim data processing device provided by the embodiment of the disclosure, after desensitization processing is carried out on the image to be identified of the claim request, the external interface is called again to carry out character identification on the desensitized image, privacy information in the image to be identified can be removed through the desensitization processing, and then the leakage of the privacy information when the external interface is called to carry out character identification on the desensitized image is avoided. Meanwhile, character recognition is carried out on the desensitization image based on an external interface, manpower and material resources can be saved, and accuracy of document recognition is improved.

An electronic device 900 according to this embodiment of the invention is described below with reference to fig. 9. The electronic device 900 shown in fig. 9 is only an example and should not bring any limitations to the function and scope of use of the embodiments of the present invention.

As shown in fig. 9, the electronic device 900 is embodied in the form of a general purpose computing device. Components of electronic device 900 may include, but are not limited to: the at least one processing unit 910, the at least one memory unit 920, and a bus 930 that couples various system components including the memory unit 920 and the processing unit 910.

Wherein the storage unit stores program code that is executable by the processing unit 910 to cause the processing unit 910 to perform steps according to various exemplary embodiments of the present invention described in the above section "exemplary methods" of the present specification. For example, the processing unit 910 may execute step S202 as shown in fig. 2: acquiring a claim settlement request, wherein the claim settlement request comprises an image to be identified; step S204: desensitizing the image to be identified to obtain a desensitized image requested by claim settlement; step S206: calling an external interface to send a desensitization image of the claim settlement request, and obtaining character recognition information returned by the external interface; step S208: and generating a claim settlement result of the claim settlement request by utilizing the character recognition information.

The storage unit 920 may include a readable medium in the form of a volatile storage unit, such as a random access memory unit (RAM)9201 and/or a cache memory unit 9202, and may further include a read only memory unit (ROM) 9203.

Storage unit 920 may also include a program/utility 9204 having a set (at least one) of program modules 9205, such program modules 9205 including but not limited to: an operating system, one or more application programs, other program modules, and program data, each of which, or some combination thereof, may comprise an implementation of a network environment.

Bus 930 can be any of several types of bus structures including a memory unit bus or memory unit controller, a peripheral bus, an accelerated graphics port, a processing unit, or a local bus using any of a variety of bus architectures.

The electronic device 900 may also communicate with one or more external devices 1000 (e.g., keyboard, pointing device, bluetooth device, etc.), with one or more devices that enable a user to interact with the electronic device 900, and/or with any devices (e.g., router, modem, etc.) that enable the electronic device 900 to communicate with one or more other computing devices. Such communication may occur via input/output (I/O) interface 950. Also, the electronic device 900 may communicate with one or more networks (e.g., a Local Area Network (LAN), a Wide Area Network (WAN) and/or a public network, such as the Internet) via the network adapter 960. As shown, the network adapter 960 communicates with the other modules of the electronic device 900 via the bus 930. It should be appreciated that although not shown, other hardware and/or software modules may be used in conjunction with the electronic device 900, including but not limited to: microcode, device drivers, redundant processing units, external disk drive arrays, RAID systems, tape drives, and data backup storage systems, among others.

Through the above description of the embodiments, those skilled in the art will readily understand that the exemplary embodiments described herein may be implemented by software, or by software in combination with necessary hardware. Therefore, the technical solution according to the embodiments of the present disclosure may be embodied in the form of a software product, which may be stored in a non-volatile storage medium (which may be a CD-ROM, a usb disk, a removable hard disk, etc.) or on a network, and includes several instructions to enable a computing device (which may be a personal computer, a server, a terminal device, or a network device, etc.) to execute the method according to the embodiments of the present disclosure.

In an exemplary embodiment of the present disclosure, there is also provided a computer-readable storage medium having stored thereon a program product capable of implementing the above-described method of the present specification. In some possible embodiments, aspects of the invention may also be implemented in the form of a program product comprising program code means for causing a terminal device to carry out the steps according to various exemplary embodiments of the invention described in the above section "exemplary methods" of the present description, when said program product is run on the terminal device.

The program product may employ any combination of one or more readable media. The readable medium may be a readable signal medium or a readable storage medium. A readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination of the foregoing. More specific examples (a non-exhaustive list) of the readable storage medium include: an electrical connection having one or more wires, a portable disk, a hard disk, a Random Access Memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing.

A computer readable signal medium may include a propagated data signal with readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated data signal may take many forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A readable signal medium may also be any readable medium that is not a readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device.

Program code embodied on a readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.

Program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, C + + or the like and conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computing device, partly on the user's device, as a stand-alone software package, partly on the user's computing device and partly on a remote computing device, or entirely on the remote computing device or server. In the case of a remote computing device, the remote computing device may be connected to the user computing device through any kind of network, including a Local Area Network (LAN) or a Wide Area Network (WAN), or may be connected to an external computing device (e.g., through the internet using an internet service provider).

Furthermore, the above-described figures are merely schematic illustrations of processes involved in methods according to exemplary embodiments of the invention, and are not intended to be limiting. It will be readily understood that the processes shown in the above figures are not intended to indicate or limit the chronological order of the processes. In addition, it is also readily understood that these processes may be performed synchronously or asynchronously, e.g., in multiple modules.

Other embodiments of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the disclosure disclosed herein. This application is intended to cover any variations, uses, or adaptations of the disclosure following, in general, the principles of the disclosure and including such departures from the present disclosure as come within known or customary practice within the art to which the disclosure pertains. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the disclosure being indicated by the following claims.

Claims

1. A method for processing claims data, comprising:

acquiring a claim settlement request, wherein the claim settlement request comprises an image to be identified;

desensitizing the image to be identified to obtain a desensitized image requested by claim settlement;

calling an external interface to send the desensitization image of the claim settlement request, and obtaining character recognition information returned by the external interface;

and generating a claim settlement result of the claim settlement request by using the character recognition information.

2. The method of claim 1, wherein performing a desensitization process on the image to be identified, obtaining a desensitized image comprises:

zooming the image to be identified according to a preset size to obtain a zoomed image;

determining an image category of the scaled image;

determining a desensitization region of the scaled image according to the image category;

and carrying out desensitization processing on the desensitization area of the scaled image to obtain the desensitization image.

3. The method of claim 2, wherein determining the image category of the scaled image comprises:

acquiring an image training set, wherein the image training set comprises sample images and classification labels of the sample images;

processing the sample image by using a machine learning model to obtain a prediction result;

determining a loss function according to the prediction result and the classification label of the sample image;

adjusting the machine learning model by using the loss function to obtain the trained machine learning model;

and processing the zoomed image according to the trained machine learning model to obtain the image classification of the zoomed image.

4. The method of claim 1, wherein invoking an external interface to send a desensitized image of the claim request, obtaining textual recognition information returned by the external interface comprises:

marking the desensitized image of the claim request according to the claim identification of the claim request;

sending the marked desensitized image to the external interface;

and receiving the text recognition information returned by the external interface according to the claim settlement identification of the claim settlement request.

5. The method of claim 1, wherein generating a claim settlement result for the claim settlement request using the textual recognition information comprises:

carrying out structuring processing on the character recognition information to obtain structured data, wherein the structured data comprises bill information and medicine information;

verifying the bill information to obtain a verification result;

searching for the repeated bill according to the bill identification in the bill information in the historical case information;

and when the verification result is that the verification result is passed and the repeated bill is found to be failed, generating a claim settlement result of the claim settlement request according to the bill information and the medicine information.

6. The method of claim 5, wherein generating a claim settlement result for the claim settlement request based on the ticket information and the drug information comprises:

determining the medicine category and the claim settlement proportion of the medicine information according to the medicine library data;

matching medical record data in the bill information with the risk information and the disease information of the claim settlement request to obtain a matching result;

and when the matching result is passed, calculating and obtaining a claim settlement result of the claim settlement request according to the medicine category and the claim settlement proportion of the medicine information and the bill information.

7. The method of claim 5, wherein generating a claim settlement result for the claim settlement request using the textual recognition information further comprises:

when the repeated bill is found successfully, the target bill corresponding to the repeated bill and the target historical claims of the repeated bill in the historical case information are obtained;

adjusting the target bill information according to the historical claim settlement result of the target historical claim to obtain adjusted bill information;

and generating the claim settlement result of the claim settlement request according to the adjustment bill information and the medicine information.

8. An claim settlement data processing apparatus, comprising:

the request acquisition module is configured to acquire a claim settlement request, and the claim settlement request comprises an image to be identified;

a desensitization processing module configured to perform desensitization processing on the image to be identified to obtain a desensitization image of the claim settlement request;

the character recognition module is configured to call an external interface to send the desensitization image of the claim settlement request, and obtain character recognition information returned by the external interface;

and the claim settlement processing module is configured to generate a claim settlement result of the claim settlement request by using the text recognition information.

9. A computer-readable medium, on which a computer program is stored, which program, when being executed by a processor, carries out the method according to any one of claims 1 to 7.

10. An electronic device, comprising:

one or more processors;

storage means for storing one or more programs which, when executed by the one or more processors, cause the one or more processors to carry out the method of any one of claims 1 to 7.