CN114119259A - Business insurance processing calculation method and device, electronic equipment and storage medium - Google Patents
Business insurance processing calculation method and device, electronic equipment and storage medium Download PDFInfo
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- CN114119259A CN114119259A CN202111387689.4A CN202111387689A CN114119259A CN 114119259 A CN114119259 A CN 114119259A CN 202111387689 A CN202111387689 A CN 202111387689A CN 114119259 A CN114119259 A CN 114119259A
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- G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
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Abstract
The application discloses a method, a device, electronic equipment and a storage medium for calculating merchant and insurance treatment, wherein the method comprises the following steps: acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entering data; and traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatments after the traversal is finished. The policy configuration data logic of the application is clear; the adaptability to complex policies of different markets is strong; the full-interface visual configuration is realized, and the operation and maintenance are convenient; the system has the advantages of fast development and excellent performance when the policy requirements change, improves the universality, the simplicity, the operation efficiency and the stability of the system, and greatly reduces the workload and the cost during later maintenance and upgrading.
Description
Technical Field
The present application relates to the field of block chain technologies, and in particular, to a method and an apparatus for calculating a quotient and guarantee treatment, an electronic device, and a storage medium.
Background
The traditional merchant insurance computing system highly depends on the relevant regulations of the area, and since the personal settlement policies of different cities are different, the merchant insurance computing systems of different areas have different computing rule requirements, the commonality of the merchant insurance computing method among the areas is poor, and the processing method has the following defects:
(1) in order to meet the policy requirements of different cities, codes need to be continuously written, logic processing blocks are added, and processing can be performed only by releasing and upgrading program versions, so that chimney-type construction causes great risks to later-stage project operation and maintenance and program stability.
(2) For the history code which is continuously increased for a long time, the later developers may not be fully understood, so in order to avoid the influence of uncertainty, a large number of logic blocks which do not need to be executed are kept in redundant execution, and the system performance and efficiency are seriously reduced along with the advance of time.
(3) Due to the fact that the coupling of historical codes is huge, the speed of developing new requirements is low, the requirements of policy change cannot be kept up with, and the workload of a system is huge.
(4) The traditional method usually needs to access a large amount of databases for value judgment, and when a large amount of services are calculated, the databases are blocked, so that the system is slow and even down.
Disclosure of Invention
In view of one of the above technical problems, the present application provides a method for calculating a business insurance policy, so as to solve the technical problems of poor generality and large workload of upgrading and maintaining of the existing method for calculating the business insurance policy.
The technical scheme adopted by the application is as follows:
a quotient insurance processing calculation method comprises the following steps:
acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entering data;
and traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatments after the traversal is finished.
Further, before acquiring medical expense detail data of the commercial insured personnel after medical insurance calculation as the entry parameter data, the method also comprises the following steps:
analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatment corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy conditions and the policy treatment into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations which describe medical insurance policy items and have logical relations, and the policy items which meet the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item.
Further, the payment mode composition comprises fund composition of the policy item, payment proportion of each fund, payment limit and time stamp.
Furthermore, after analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy items and the policy treatments in a merchant insurance parameter library, the method further comprises the following steps:
and refreshing the treatment policy, namely combining the data arranged and stored in the quotient insurance parameter base into data which can be identified by an algorithm model according to the rule of quotient insurance treatment calculation, and storing the data into a memory database to be used as a quotient insurance algorithm base for the use of the quotient insurance treatment calculation.
Further, the merchant insurance parameter library adopts Mysql, SQL SERVER, DB and ORECLE; the memory database comprises Memcached, redis and Mongo DB.
Further, traversing the pre-arranged policy items, comparing the elements of the input data with the element expressions of the policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatments after the traversal is completed, which specifically comprises the following steps:
traversing the expense details of the parameter entering data;
traversing a commodity insurance algorithm library, and comparing elements of the entry data with element expressions of policy conditions in all policy items, wherein the elements are minimum units of objects related to treatment calculation in the process of calculating medical insurance treatment;
if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and otherwise, continuously traversing the underwriting algorithm library;
if all policy items in the commodity insurance algorithm library are completely traversed, summarizing the calculation results to obtain a final calculation result and outputting the final calculation result, and otherwise, continuously traversing the commodity insurance algorithm library.
In another aspect, the present application further provides a quotient and guarantee treatment computing device, including:
the system comprises a parameter entry data acquisition module, a parameter entry data processing module and a parameter entry data processing module, wherein the parameter entry data acquisition module is used for acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entry data;
and the quotient and insurance processing calculation module is used for traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially operating the calculation processes of the policy processing in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and insurance processing after the traversal is finished.
Further, still include:
the policy arrangement module is used for analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy items and the policy conditions and the policy treatments into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations with logical relations and describing medical insurance policy items, and the policy items meeting the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item.
The present application further provides an electronic device, which includes a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the computer program to implement the quotient guarantee calculation method.
In another aspect, the present application further provides a storage medium, where the storage medium includes a stored program, and when the program runs, the apparatus on which the storage medium is located is controlled to execute the quotient guarantee calculation method.
Compared with the prior art, the method has the following beneficial effects:
the application provides a merchant insurance processing calculation method, a merchant insurance processing calculation device, electronic equipment and a storage medium, wherein the merchant insurance processing calculation method comprises the following steps: acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entering data; and traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if business policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the business treatment after the traversal is finished. When the method is used for calculating the merchant insurance encounter, elements of the access data are compared with element expressions of policy conditions in all policy items through the pre-arranged policy items, business policy items meeting the conditions are found, and the calculation process of the policy encounter in the matched policy items is sequentially operated according to the specified sequence, so that the merchant insurance encounter calculation can be obtained, when the method is applied to the merchant insurance encounter calculation of different regions, the corresponding policy items are only required to be rearranged in advance according to the corresponding rules according to local merchant insurance policy information, and any adjustment is not required to be made on other partial modules and codes of the system, so that the method can realize that one set of system is used for multiple purposes, and has the following advantages: the policy configuration data logic is clear; the adaptability to complex policies of different markets is strong; the full-interface visual configuration is realized, and the operation and maintenance are convenient; the development is fast when the policy requirements change; the performance is excellent. The universality, the simplicity, the operation efficiency and the stability of the system are improved, and meanwhile, the workload and the cost during later maintenance and upgrading are greatly reduced.
In addition to the objects, features and advantages described above, other objects, features and advantages will be apparent from the present application. The present application will now be described in further detail with reference to the accompanying drawings.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the application and, together with the description, serve to explain the application and are not intended to limit the application. In the drawings:
fig. 1 is a flow chart of a quotient guarantee calculation method according to a preferred embodiment of the present application.
Fig. 2 is a schematic flow chart of a quotient guarantee calculation method according to another preferred embodiment of the present application.
Fig. 3 is a schematic diagram of the policy arrangement principle of the preferred embodiment of the present application.
Fig. 4 is a schematic diagram of a policy item maintenance visualization interface according to a preferred embodiment of the present application.
Fig. 5 is a schematic diagram of a policy item information visualization interface according to a preferred embodiment of the present application.
Fig. 6 is a schematic view of an execution condition visualization interface according to a preferred embodiment of the present application.
Fig. 7 is a diagram of a settlement policy composition visualization interface according to a preferred embodiment of the present application.
Fig. 8 is a schematic flow chart of another preferred quotient and guarantee calculation method according to the present application.
Fig. 9 is a schematic view of a refresh policy visualization interface according to a preferred embodiment of the present application.
Fig. 10 is a detailed sub-step diagram of step S4 in the preferred embodiment of the present application.
Fig. 11 is a schematic general flow chart of a quotient guarantee calculation method according to the preferred embodiment of the present application.
FIG. 12 is a block diagram of a merchant's care computing device in accordance with a preferred embodiment of the present application.
FIG. 13 is a block diagram of a merchant insurance processing computing device according to another preferred embodiment of the present application.
Fig. 14 is a schematic block diagram of an electronic device entity of the preferred embodiment of the present application.
Fig. 15 is an internal structural view of a computer device of the preferred embodiment of the present application.
Detailed Description
It should be noted that the embodiments and features of the embodiments in the present application may be combined with each other without conflict. The present application will be described in detail below with reference to the embodiments with reference to the attached drawings.
For the sake of understanding, the technical terms involved in the quotient-guarantee calculation method are explained first.
And (4) policy items: the order composition items in the commercial medical insurance policy, such as payment standard, overall stage, and business insurance stage.
And (3) policy conditions: the element expression combination with logical relation describing the medical insurance policy item can find the policy item meeting the condition by judging the expression combination logic of the elements.
Policy handling: the payment mode composition of the policy item comprises fund composition of the policy item, payment proportion, payment limit, time stamp and the like of each fund.
The elements are as follows: the minimum unit of an object related to the treatment calculation in the medical insurance treatment calculation process is referred to;
a merchant security parameter library: and a database for storing the elements, the policy items, the policy conditions and the policy treatment data.
The algorithm library of the trade insurance: and combining the data of the merchant insurance parameter base into data which can be identified by the algorithm model, and storing the data into a memory database redis.
An algorithm model: the method is a whole set of complete maintainable and developable program for complex calculation of medical insurance treatment by arranging parameters, elements and the like and adopting an algorithm scheduling mode.
As shown in fig. 1, a preferred embodiment of the present application provides a quotient and reservation computing method, including the steps of:
s3, acquiring medical expense detailed data of the commercial insured personnel after medical insurance calculation as parameter entering data;
and S4, traversing the pre-arranged policy items, comparing the elements of the input data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatment after the traversal is finished.
The embodiment provides a quotient and guarantee calculation method, which comprises the following steps: acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entering data; and traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if business policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the business treatment after the traversal is finished. When the embodiment is used for calculating the merchant insurance, the elements of the access data are compared with the element expressions of the policy conditions in all the policy items through the pre-arranged policy items, the business policy items meeting the conditions are found, and the calculation process of the policy treatment in the matched policy items is sequentially operated according to the specified sequence, so that the merchant insurance calculation can be obtained, when the method is applied to the merchant insurance calculation of different city areas, the corresponding policy items are only required to be rearranged in advance according to the corresponding rules according to the local merchant insurance policy information, and any adjustment is not required to be made on other part of modules and codes of the system, so that the one set of system can be used for many times, and the method has the following advantages: the policy configuration data logic is clear; the adaptability to complex policies of different markets is strong; the full-interface visual configuration is realized, and the operation and maintenance are convenient; the development is fast when the policy requirements change; the performance is excellent. The universality, the simplicity, the operation efficiency and the stability of the system are improved, and meanwhile, the workload and the cost during later maintenance and upgrading are greatly reduced.
As shown in fig. 2, in the preferred embodiment of the present application, before acquiring the medical expense detail data calculated by the medical insurance of the business insured personnel as the entry parameter data, the method further includes the following steps:
s1, analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy conditions and the policy treatments into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations with logical relations and describing medical insurance policy items, and the policy items meeting the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item, and the payment mode composition comprises fund composition of the policy item, payment proportion of each fund, payment limit and time stamp.
In this embodiment, a process of policy arrangement is disclosed, and fig. 3 illustrates an example of a policy that an employee stores a section of policy in a third-level hospital, where the policy information of the local merchant is analyzed and abstracted, and all policy terms, policy conditions corresponding to the policy terms, and policy treatment are extracted from the policy information of the merchant, where the policy terms are the merchant section, the policy conditions are the employee, the third-level hospital, the hospital, and the merchant security risk, and the policy treatment maintains the reimbursement proportion and the composition of the funds such as the merchant fund and the personal cash. When the insured person visits the doctor in the foreground, the processes of treatment calculation are carried out in sequence according to the sequence of the policy items, and the results after the calculation of all the policy items meeting the policy conditions are finished are the cost constitution of the insured person seeking the doctor at this time: the algorithm principle of the invention is as follows: under what conditions, what treatment is enjoyed. All calculation policies can analyze the policy conditions and the constitution thereof, so all policy items meeting the policy conditions are calculated because the treatment calculation is often constrained by different policy information of each city, for example, when the reimbursement cost of one person exceeds 2 ten thousand, according to the local policy, one reimbursement calculation proportion exists for the cost within 1 ten thousand, and another reimbursement calculation proportion exists for the part exceeding 1 ten thousand, so that two different policy items meeting the policy conditions are corresponded, therefore, all policy items meeting the conditions must be subjected to the treatment calculation, and subsequently, when the reimbursement cost is calculated, each policy item meeting the conditions must be calculated according to the sequence specified by each local area, that is, the attributes of the policy items include the execution sequence determined by the local medical insurance policy, and the different sequences directly influence the final result, only if the calculation is carried out according to the specified sequence, the calculation result meeting the requirements can be obtained, and the result shows that the cost of the patient for the medical care is formed as follows: the amount of the payment is reported by the merchant insurance and the amount of the self-payment of the personal cash. This diagram represents the basic principle of the present embodiment: under what conditions, what treatment is enjoyed. All computational policies can be analyzed for its policy conditions and its composition.
The function module interface for policy orchestration in the present application is described below.
As shown in fig. 4, a visual interface for maintaining policy items is provided, through which the configuration of policy items included in the medical insurance zone, including medical insurance zone, policy item name, policy item code, policy item description, latest editing time, validity, etc., can be conveniently defined, and through which a user can query, add, delete, export, etc., the policy items.
The settlement policy management interface is used for maintaining conditions and treatment composition of the merchant insurance policy items, comprises three contents, firstly selects the policy items and fills in data such as product codes, timestamps, execution sequences and the like (see figure 5), then writes corresponding policy conditions according to configured policy scenes (see figure 6), and finally composes arrangement fund types, reimbursement proportions, calculation limits and the like in the settlement policy (see figure 7).
As shown in fig. 8, in the preferred embodiment of the present application, after analyzing and abstracting local policy information of the merchant insurance, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the policy information of the merchant insurance, and arranging and storing the policy conditions and policy treatments in the parameter library of the merchant insurance, the method further includes the steps of:
s2, refreshing a treatment policy, combining the data arranged and stored in the quotient insurance parameter base into identifiable data according to the rule of quotient insurance calculation, and storing the identifiable data in the memory database as a quotient insurance algorithm base for use in quotient insurance calculation.
Specifically, the quotient insurance parameter library adopts Mysql, SQL SERVER, DB and ORECLE; the memory database comprises Memcached, redis and Mongo DB, in the embodiment, the merchant security parameter database adopts Mysql, and the memory database adopts redis.
In this embodiment, before performing formal treatment calculation, treatment policy refreshing is performed, that is, the arrangement is stored in the data in the underwriters parameter library (Mysql database), combining according to the rules of the algorithm model, storing the algorithm model into a merchant algorithm database (memory database redis), providing the algorithm model for a calculation interface to use when calling the algorithm model for calculation, thus, frequent data interaction with the Mysql database can be reduced, the performance can be improved, FIG. 9 is a waiting policy refreshing interface, a refreshing policy button in the interface is clicked, namely, the data in the parameter bank of the merchant insurance (Mysql database) is combined according to the rules of the algorithm model and then stored in the algorithm bank of the merchant insurance (the memory database redis) for the calculation interface to call the algorithm model for calculation, all the operations on the data are carried out in the memory, so that frequent interaction with the database is reduced, and the system performance during large data processing is improved.
Specifically, as shown in fig. 10, in a preferred embodiment of the present application, a pre-arranged policy item is traversed, elements of the parameter data are compared with element expressions of policy conditions in all policy items, if a policy item meeting the condition is found, a calculation process of policy treatment in each policy item is sequentially run according to a specified order, and calculation results of quotient and guarantee treatments are summarized and output after the traversal is completed, which specifically includes the steps of:
s41, traversing the expense details of the parameter entering data;
s42, traversing the policy items in the underwriting algorithm library;
s43, comparing the element of the parameter data with element expressions of policy conditions in all policy items, and judging whether the policy conditions are met;
s44, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, otherwise, continuously traversing the underwriting algorithm library;
s45, judging whether all the policy items in the underwriting algorithm library are completely traversed;
and S46, if all the policy items in the underwriting algorithm library are completely traversed, summarizing the calculation results to obtain a final calculation result and outputting the final calculation result, otherwise, continuously traversing the underwriting algorithm library.
The embodiment discloses the process of calculating the merchant insurance acceptance by traversing the merchant insurance algorithm library and condition matching through the algorithm model in detail, and it can be seen that, in the method of the embodiment, no matter the merchant insurance acceptance is used for calculating the merchant insurance acceptance of any local market, the specific flow of the algorithm model is consistent, the only difference is that the data in the traversed merchant insurance algorithm library is different, namely, each local market can correspond to the merchant insurance algorithm library with different contents according to the difference of the merchant insurance policy information of the local market, the data in the merchant insurance database is from the merchant insurance parameter library which is arranged and stored through each visual interface in advance, because of the universality of the algorithm model, the embodiment can be conveniently implemented and used in different local market areas without being influenced by the merchant insurance policy information of each local area, that is, the method couples and separates the policy item during the merchant insurance acceptance calculation with the algorithm model, when the algorithm model needs to calculate the merchant insurance treatment, the merchant insurance treatment meeting the requirements of the policies of various regions can be calculated only by calling the merchant insurance algorithm library corresponding to the merchant insurance policy information of various regions, through the decoupling separation, not only can the policy configuration be flexibly arranged, but also the configured policy data can be executed by relying on the algorithm model to generate corresponding results, the goal of applying and deploying the system in various regions is realized only by developing one set of system, the universality, the simplicity, the operation efficiency and the stability of the system are improved, and meanwhile, the workload and the cost during later maintenance and upgrading are greatly reduced.
Fig. 11 is a general flow diagram of the present application: the method comprises the following steps that the information of the merchant security policy is arranged through a system interface and then stored in a merchant security parameter base (Mysql database), the merchant security policy refreshes data extracted from the merchant security parameter base and issued to a merchant security algorithm base (Redis memory database), algorithm scheduling and merchant security policy calculation circularly traverse the data of the merchant security policy extracted from the merchant security algorithm base for calculation, and finally corresponding calculation results are generated, so that the embodiment of the method has the following characteristics:
(1) the requirements of policy making and quick online of different cities can be met only by adjusting the configuration of policy parameters without upgrading programs or redundant code operation and maintenance.
(2) The historical policy data can be easily found out on the arrangement interface, and is visual and clear.
(3) The algorithm model has no database connection, all calculation-related policy data are in a memory, cache means of redis and ehcache are fully utilized, calculation under the condition of large concurrency is carried out, and the performance bottleneck is eliminated.
As shown in fig. 12, another aspect of the present application further provides a quotient insurance processing computing apparatus, including:
the system comprises a parameter entry data acquisition module, a parameter entry data processing module and a parameter entry data processing module, wherein the parameter entry data acquisition module is used for acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entry data;
and the quotient and insurance processing calculation module is used for traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially operating the calculation processes of the policy processing in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and insurance processing after the traversal is finished.
Specifically, as shown in fig. 13, the quotient guarantee processing computing device further includes:
the policy arrangement module is used for analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy items and the policy conditions and the policy treatments into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations with logical relations and describing medical insurance policy items, and the policy items meeting the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item.
As shown in fig. 14, the preferred embodiment of the present application further provides an electronic device, which includes a memory, a processor, and a computer program stored in the memory and executable on the processor, and the processor executes the computer program to implement the quotient guarantee calculation method.
As shown in fig. 15, the preferred embodiment of the present application also provides a computer device, the internal structure of which can be as shown in fig. 15. The computer device includes a processor, a memory, and a network interface connected by a system bus. Wherein the processor of the computer device is configured to provide computing and control capabilities. The memory of the computer device comprises a nonvolatile storage medium and an internal memory. The non-volatile storage medium stores an operating system and a computer program. The internal memory provides an environment for the operation of an operating system and computer programs in the non-volatile storage medium. The network interface of the computer device is used for communicating with other external computer devices through network connection. The computer program is executed by a processor to implement the quotient guarantee calculation method described above.
Those skilled in the art will appreciate that the architecture shown in fig. 15 is merely a block diagram of some of the structures associated with the disclosed aspects and is not intended to limit the computing devices to which the disclosed aspects apply, as particular computing devices may include more or less devices than those shown, or may combine certain devices, or have a different arrangement of devices.
The present application further provides a storage medium, where the storage medium includes a stored program, and when the program runs, the apparatus where the storage medium is located is controlled to execute the quotient guarantee treatment calculation method.
It should be noted that the steps illustrated in the flowcharts of the figures may be performed in a computer system such as a set of computer-executable instructions and that, although a logical order is illustrated in the flowcharts, in some cases, the steps illustrated or described may be performed in an order different than presented herein.
The functions of the method of the present embodiment, if implemented in the form of software functional units and sold or used as independent products, may be stored in one or more storage media readable by a computing device. Based on such understanding, part of the contribution to the prior art of the embodiments of the present application or part of the technical solution may be embodied in the form of a software product stored in a storage medium and including several instructions for causing a computing device (which may be a personal computer, a server, a mobile computing device or a network device) to execute all or part of the steps of the method described in the embodiments of the present application. And the aforementioned storage medium includes: a U-disk, a removable hard disk, a Read-Only Memory (ROM), a Random Access Memory (RAM), a magnetic disk or an optical disk, and other various media capable of storing program codes.
The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like made within the spirit and principle of the present application shall be included in the protection scope of the present application.
Claims (10)
1. A quotient guarantee treatment calculation method is characterized by comprising the following steps:
acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entering data;
and traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatments after the traversal is finished.
2. The quotient guaranty calculation method of claim 1,
before medical expense detailed data calculated by the commercial insurer is obtained as the entry parameter data, the method further comprises the following steps:
analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatment corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy conditions and the policy treatment into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations which describe medical insurance policy items and have logical relations, and the policy items which meet the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item.
3. The quotient insurance transaction calculation method of claim 2, wherein
The payment mode composition comprises fund composition of the policy item, payment proportion of each fund, payment limit and time stamp.
4. The quotient guaranty calculation method of claim 1,
analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatment corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy conditions and the policy treatment into a merchant insurance parameter library, and further comprising the following steps:
and refreshing the treatment policy, namely combining the data arranged and stored in the quotient insurance parameter base into data which can be identified by an algorithm model according to the rule of quotient insurance treatment calculation, and storing the data into a memory database to be used as a quotient insurance algorithm base for the use of the quotient insurance treatment calculation.
5. The quotient guaranty calculation method of claim 4,
the merchant security parameter library adopts Mysql, SQL SERVER, DB and ORECLE; the memory database comprises Memcached, redis and Mongo DB.
6. The quotient guaranty calculation method of claim 4,
traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and guarantee treatments after the traversal is completed, which specifically comprises the following steps:
traversing the expense details of the parameter entering data;
traversing policy items in the commodity insurance algorithm library;
comparing the element of the parameter data with element expressions of policy conditions in all policy items, and judging whether the policy conditions are met;
if the policy items meeting the conditions are found, sequentially running the calculation process of the policy treatment in each policy item according to a specified sequence, and otherwise, continuously traversing the underwriting algorithm library;
judging whether all policy items in the commodity insurance algorithm library are completely traversed;
if all policy items in the commodity insurance algorithm library are completely traversed, summarizing the calculation results to obtain a final calculation result and outputting the final calculation result, and otherwise, continuously traversing the commodity insurance algorithm library.
7. A merchant encounter computing device, comprising:
the system comprises a parameter entry data acquisition module, a parameter entry data processing module and a parameter entry data processing module, wherein the parameter entry data acquisition module is used for acquiring medical expense detailed data of commercial insured personnel after medical insurance calculation as parameter entry data;
and the quotient and insurance processing calculation module is used for traversing the pre-arranged policy items, comparing the elements of the input parameter data with element expressions of policy conditions in all the policy items, if the policy items meeting the conditions are found, sequentially operating the calculation processes of the policy processing in each policy item according to a specified sequence, and summarizing and outputting the calculation results of the quotient and insurance processing after the traversal is finished.
8. The quotient insurance transaction computing apparatus of claim 7, further comprising:
the policy arrangement module is used for analyzing and abstracting local merchant insurance policy information, extracting all policy items, policy conditions and policy treatments corresponding to the policy items from the merchant insurance policy information, arranging and storing the policy items and the policy conditions and the policy treatments into a merchant insurance parameter library, wherein the policy items refer to sequential composition items in a local commercial medical insurance policy, the policy conditions refer to element expression combinations with logical relations and describing medical insurance policy items, and the policy items meeting the conditions are found by judging element expression combination logic; the policy treatment refers to the payment mode composition of the policy item.
9. An electronic device comprising a memory, a processor, and a computer program stored on the memory and executable on the processor, wherein the processor implements the quotient guarantee calculation method according to any one of claims 1 to 6 when executing the program.
10. A storage medium including a stored program, characterized in that a device on which the storage medium is located is controlled to execute the quotient guarantee calculation method according to any one of claims 1 to 6 when the program runs.
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Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2010102551A (en) * | 2008-10-24 | 2010-05-06 | Hitachi Ltd | Multi insurance system cooperation system, and method of combining high-cost medical care expense |
| CN106295151A (en) * | 2016-08-03 | 2017-01-04 | 合肥奇也信息科技有限公司 | A kind of medical care insurance is settled a claim system online |
| CN107767277A (en) * | 2017-11-10 | 2018-03-06 | 平安科技（深圳）有限公司 | Medical insurance settlement method and system, insurance terminal, computer-readable recording medium |
| CN108154443A (en) * | 2017-07-18 | 2018-06-12 | 邹鑫洋 | A kind of medical treatment medical insurance data processing equipment and method |
| CN110428341A (en) * | 2019-08-06 | 2019-11-08 | 哈尔滨工业大学软件工程股份有限公司 | Medical insurance settlement method, equipment and computer readable storage medium |
-
2021
- 2021-11-22 CN CN202111387689.4A patent/CN114119259A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2010102551A (en) * | 2008-10-24 | 2010-05-06 | Hitachi Ltd | Multi insurance system cooperation system, and method of combining high-cost medical care expense |
| CN106295151A (en) * | 2016-08-03 | 2017-01-04 | 合肥奇也信息科技有限公司 | A kind of medical care insurance is settled a claim system online |
| CN108154443A (en) * | 2017-07-18 | 2018-06-12 | 邹鑫洋 | A kind of medical treatment medical insurance data processing equipment and method |
| CN107767277A (en) * | 2017-11-10 | 2018-03-06 | 平安科技（深圳）有限公司 | Medical insurance settlement method and system, insurance terminal, computer-readable recording medium |
| CN110428341A (en) * | 2019-08-06 | 2019-11-08 | 哈尔滨工业大学软件工程股份有限公司 | Medical insurance settlement method, equipment and computer readable storage medium |
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