WO2019161602A1 - 账单的注释生成方法、装置和计算机可读存储介质 - Google Patents

账单的注释生成方法、装置和计算机可读存储介质 Download PDF

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Publication number
WO2019161602A1
WO2019161602A1 PCT/CN2018/082705 CN2018082705W WO2019161602A1 WO 2019161602 A1 WO2019161602 A1 WO 2019161602A1 CN 2018082705 W CN2018082705 W CN 2018082705W WO 2019161602 A1 WO2019161602 A1 WO 2019161602A1
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Prior art keywords
amount
bill
payout
user
determining
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PCT/CN2018/082705
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English (en)
French (fr)
Inventor
李响
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平安科技(深圳)有限公司
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Publication of WO2019161602A1 publication Critical patent/WO2019161602A1/zh

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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08Insurance
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • G06Q10/10Office automation; Time management
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q30/00Commerce
    • G06Q30/04Billing or invoicing

Definitions

  • the present application relates to the field of communications technologies, and in particular, to a bill generating method, apparatus, and computer readable storage medium.
  • the user who purchases the insurance gets the claim statement, since the user cannot determine whether the claim amount of the claim statement is reasonable, the user will consult the customer service, and the length of the entire claim process is increased, that is, the claim settlement efficiency is low.
  • the main purpose of the present application is to provide a bill generating method, apparatus, and computer readable storage medium, which are intended to have a problem of low billing efficiency.
  • the present application provides a method for generating a note of a bill, and the method for generating a note of the bill includes the following steps:
  • the payment amount of the user bill and the annotation information of the payment amount are output.
  • the step of generating the annotation information corresponding to the claim amount according to the claim product information comprises:
  • the annotation information of the payment amount is generated according to the calculation basis and the calculation manner.
  • the step of determining the payment amount of the user bill according to the claim product information comprises:
  • the step of determining the payment amount of the user bill according to the payment amount of each of the claims objects comprises:
  • the step of determining the payment amount of the collection according to the compensation amount of the collection and the amount thereof comprises:
  • the payout amount of the set is greater than or equal to the to-be-paid amount of the set, and the to-be-paid amount of the set is used as the payout amount of the set;
  • the compensation amount of the collection is less than the to-be-paid amount of the collection, the compensation amount of the collection is used as the compensation amount of the collection.
  • the method further includes:
  • the step of determining the payout amount of the user bill according to the claim product information is performed.
  • the step of determining whether the bill generation time point is in the expiration date further comprises:
  • the reject information is generated and output.
  • the method further includes:
  • Generating annotation information corresponding to the non-pay object and outputting the payment amount of the user bill, the annotation information corresponding to the payment amount of the user bill, the non-payment object, and the annotation information corresponding to the non-payment object, wherein
  • the annotation information of the non-pay object includes the reason for the non-compensation object.
  • the present application also provides an annotation generating apparatus for billing, the bill generating apparatus of the billing comprising a processor, a memory, and a comment generation of a bill stored on the memory and executable on the processor A program, the step of implementing the annotation generation method of the bill as described above when the annotation generation program of the bill is executed by the processor.
  • the present application also provides a computer readable storage medium storing a bill generating program of a bill, the bill generating program of the bill being implemented by the processor as described above The steps of the bill generation method of the bill.
  • the present application provides a bill generating method, apparatus, and computer readable storage medium.
  • the bill generating device obtains a user bill and user information according to the request, and then obtains a claim associated with the user information.
  • Product information and then determining the payment amount of the user bill according to the claim product information, and generating the annotation information corresponding to the compensation amount according to the claim product information, and finally outputting the payment amount of the user bill and the annotation information of the payment amount;
  • the bill generation device can output
  • the payment amount of the user bill and the annotation information of the payment amount enable the user to obtain the calculation method and the calculation basis of the payment amount according to the annotation information, thereby reducing the doubt of the user's statement, and avoiding the user asking the customer service for the problem of increasing the length of the bill settlement, and improving the problem.
  • the billing efficiency of the bill is a bill generating method, apparatus, and computer readable storage medium.
  • FIG. 1 is a schematic structural diagram of hardware of a bill generating apparatus according to an embodiment of the present application
  • FIG. 2 is a schematic flow chart of a first embodiment of a method for generating a note of a bill of the present application
  • FIG. 3 is a schematic diagram of a refinement process for determining a payment amount of the user bill according to the claim product information in step S200 of FIG. 2;
  • step S300 in FIG. 2 is a schematic diagram of a refinement process of step S300 in FIG. 2;
  • FIG. 5 is a schematic flowchart diagram of a second embodiment of a method for generating a comment of a bill of the present application.
  • the main solution of the embodiment of the present application is: when receiving the billing adjustment request, acquiring the user bill and the user information according to the billing adjustment request; acquiring the claim product information associated with the user information, and determining according to the claim product information The payment amount of the user bill; the annotation information corresponding to the compensation amount is generated according to the claim product information, wherein the annotation information of the payment amount includes a calculation method of the payment amount and/or a calculation basis of the compensation amount; The amount of the payment of the user's bill and the annotation information of the amount of the claim.
  • the present application provides a solution in which the bill generating means of the bill can output the payout amount of the user bill and the billing amount of the payout amount, so that the user can obtain the calculation method of the payout amount and the calculation basis according to the annotation information, thereby reducing the user's bill. Doubt, avoiding the user asking the customer service for the problem of increasing the length of the bill settlement, and improving the claim efficiency of the bill.
  • a hardware structure diagram of the bill generating apparatus of the bill in the embodiment of the present application may be as shown in FIG. 1 .
  • the bill generating means of the bill may include a processor 1001, such as a CPU, a memory 1002, and a communication bus 1003.
  • the communication bus 1003 is used to implement connection communication between the components of the bill generating device of the bill.
  • the memory 1002 may be a high speed RAM memory or a stable memory (non-volatile) Memory), such as disk storage.
  • the memory 1002 can also optionally be a storage device independent of the aforementioned processor 1001.
  • a note generation program for billing may be included in the memory 1002 as a computer storage medium.
  • the processor 1001 can be used to call the bill generating program of the bill stored in the memory 1002, and execute each step of the bill generating method of the bill in each of the following embodiments. .
  • the bill generating device when the billing request generating device receives the billing request, the bill generating device obtains the user bill and the user information according to the request, and then obtains the claim product information associated with the user information, and then determines the user bill according to the claim product information.
  • the payment amount is generated, and the annotation information corresponding to the payment amount is generated according to the claim product information, and finally the payment amount of the user bill and the annotation information of the payment amount are output;
  • the bill generation device of the bill can output the payment amount of the user bill and the annotation information of the payment amount.
  • the user can obtain the calculation method and the calculation basis of the payment amount according to the annotation information, thereby reducing the doubt of the user's bill, avoiding the user asking the customer service for the problem that the billing claim is growing, and improving the claim efficiency of the bill.
  • FIG. 2 is a first embodiment of a method for generating a note of a bill of the present application, and the method for generating a note of the bill includes the following steps:
  • Step S100 when receiving the billing adjustment request, acquiring the user bill and the user information according to the billing adjustment request;
  • the execution subject is a bill generating means for billing.
  • the user can upload the bill requiring the claim to the bill generating device of the bill through the APP associated with the claim generating device of the claim bill, that is, the user can send the billing adjustment to the bill generating device through the APP.
  • the request, the billing request includes a user bill; the user bill contains the name of the user, and the bill generating device can obtain the corresponding user information according to the name of the user.
  • the user's bill must be stamped with the official seal of the unit that generated the user's bill, that is, the bill generating device of the bill needs to determine whether the user's bill contains the official seal of the unit.
  • the bill generation device of the bill obtains the type of the user bill after obtaining the user bill and the user information, and determines the type of the claim product purchased by the user according to the user information, and further determines whether the type of the user bill is related to the claim product. Whether the type of the user is consistent, for example, the user bill is a hospital bill, and the claim product purchased by the user is auto insurance, then the user bill uploaded by the user does not match the claim product. At this time, the bill generating device of the bill outputs the user bill type error. A reminder message to remind the user to upload the correct user bill.
  • Step S200 Obtain the claim product information associated with the user information, and determine the amount of the payment of the user bill according to the claim product information;
  • the bill generating device After the bill generating device obtains the user information, the claim product purchased by the user is determined according to the user information, thereby obtaining the corresponding claim product information, and then determining the payout amount of the user bill according to the claim product information. Specifically, refer to FIG. 3 . That is, the step of determining the payment amount of the user bill according to the claim product information in step S200 includes:
  • Step S210 determining, according to the claim product information, each pay object in the user bill;
  • the claim product information includes the object that can be paid.
  • the claim product purchased by the user is a health insurance
  • the medicine in the hospital can be reimbursed, and the health insurance has multiple types, and each type of health insurance pays for different drugs.
  • high-grade health insurance can pay for Class A, B, and C drugs.
  • Class A, B, and C drugs can be differentiated according to price. For example, drugs with 0-200 yuan are classified as Class A drugs.
  • A, B, C class three drugs can also be differentiated according to the type of drugs; user bills contain individual drugs corresponding The amount of money, the bill generating means of the bill can determine the type of the medicine according to the amount of the medicine, and if the medicine is any of the types A, B, and C, the medicine is the object of payment in the user's bill.
  • Step S220 determining a payment amount of each of the claims objects, and superimposing the payment amount of each of the claims objects to obtain a payment amount of the user bill;
  • the bill generating means of the bill may, after determining the respective payout objects in the user bill, superimpose the payout amount of each payee object to obtain the payout amount of the user bill.
  • the device determines the validity period of the claim product purchased by the user according to the claim product information, and then obtains the bill generation time point in the user bill, and then determines whether the bill generation time point is valid in the claim product. Within the time limit, if the bill generation time point is within the validity period of the claim product, the next step is performed; if the bill generation time point is not within the validity period of the claim product, the reject information is generated and outputted, and the reject information may be rejected. Reason, for example, a reminder that the bill has expired.
  • Step S300 generating annotation information corresponding to the compensation amount according to the claim product information, where the annotation information of the payment amount includes a calculation method of the compensation amount and/or a calculation basis of the compensation amount;
  • step S300 includes:
  • Step S310 determining, according to the claim product information, a calculation method corresponding to the claim amount and a calculation basis;
  • the amount of the bill's payment is determined by the amount of the payout of each bill of the bill. After the bill generation means of the bill determines the payout amount, the calculation basis and the payout amount of each payout object are determined, and then the payout amount of each payout object is superimposed to obtain a calculation formula (calculation method) of the payout amount.
  • Step S320 generating annotation information of the payment amount according to the calculation basis and the calculation manner
  • the bill generating means of the bill generates the comment information of the payout amount after determining the calculation basis and the calculation method of the payout amount. Specifically, when determining the object to be paid in the bill, the device generates a reason for determining the object to be paid.
  • the object to be paid is the drug “glucose”, and the glucose belongs to the class A drug, and the reason for the object of the claim is: “glucose is 20 yuan.
  • the device After determining the respective compensation objects of the bill, the device will The amount of each payout object is superimposed to obtain the payout amount of the bill, and a superposition formula is generated, which is a calculation method corresponding to the payout amount; it can be understood that the comment information of the payout amount of the bill is corresponding to each payout object of the bill.
  • the judgment reason and the superposition formula of the amount corresponding to each claim object are composed.
  • the bill generating means adjusts the claim product information, and obtains the claim product purchased by the user in the claim product information, thereby annotating the type that the user can pay (the comment may be " User A can pay for the Class A drug "), or the bill generating device can annotate the type of payment purchased by the user in the claim product contract (the comment can be "User A purchases a type of drug"), or directly Output the user's claim product contract, further reducing the user's doubts.
  • Step S400 outputting a payment amount of the user bill and annotation information of the payment amount
  • the bill generating means After the bill generating means generates the comment information corresponding to the payout amount, the billing amount and the comment information corresponding to the payout amount are output, so that the user can clearly know the claim rule of the user bill based on the comment information, thereby reducing the user's doubt.
  • the bill annotation generating device may determine the non-pay object in the user information according to the claim product information, and determine that the non-pay object in the user bill is the same as the claim object for determining the user bill, and will not be repeated here;
  • the device generates annotation information of the non-payment object, for example, the non-payment object is medicine glucose, and the annotation information is “glucose is a type A medicine, and is not a claim object of the claim product” (the annotation information of the non-pay object is the non-compensation object rejection) Cause)
  • the device outputs the non-payout object, the comment information of the non-pay object, the payout amount of the user bill, and the comment information of the payout amount.
  • the bill generating device when receiving the billing adjustment request, obtains the user bill and the user information according to the request, and then obtains the claim product information associated with the user information, and then determines the user according to the claim product information.
  • the payment amount of the bill, and the annotation information corresponding to the payment amount is generated based on the claim product information, and finally the payment amount of the user bill and the annotation information of the payment amount are output; the bill generation device of the bill can output the payment amount of the user bill and the annotation of the payment amount
  • the information enables the user to obtain the calculation method and calculation basis of the claim amount according to the annotation information, thereby reducing the doubt of the user's bill, avoiding the user's inquiry to the customer service and causing the problem of the increase of the bill claim period, and improving the claim efficiency of the bill.
  • FIG. 5 is a second embodiment of a method for generating a bill of notes according to the present application.
  • the step of determining, according to the claim amount of each pay object, the payout amount of the user bill in the step S210 includes:
  • Step S211 determining a payment type of each of the claims objects, and aggregating the claims objects of the same payout type to obtain a plurality of sets;
  • the bill generating means of the bill first determines the type of each object in the user bill before determining the paying object in the user bill according to the claim product information, and then determines the type of the claim according to the claim product information, if the type of the object in the user bill is the paying type
  • the object is a payout object, that is, the bill generating means of the bill also determines the type of payout corresponding to the payee object when determining the payout object.
  • the paying objects of the same paying type are aggregated, thereby obtaining a plurality of sets, each of which corresponds to one type of payout.
  • Step S212 calculating, according to the compensation amount of each of the claims objects, the to-be-processed payment amount of each of the collections;
  • the device After determining the payment amount of each paying object in the set, the device superimposes the payout amount of each paying object of the set, thereby obtaining the to-be-paid amount of the set, and so on, the device may determine the to-be-paid amount of each set to be processed. Step S213, determining, according to the claim product information, a payout amount corresponding to each claim type, and using the payout amount corresponding to the payout type as the payout amount of the set corresponding to the payout type;
  • the claim type in the claim product has a corresponding payout amount.
  • the payout amount of the class A product is 3,000 yuan; the device may use the payout amount corresponding to the payout type as the payout amount of the set corresponding to the type.
  • Step S214 determining a payment amount of the set according to the compensation amount of the set and the amount of the payment to be processed, and determining the payment amount of the bill according to the payment amount of each of the collections;
  • the device After determining the to-be-paid amount of the collection and the amount of the payment, the device determines the amount of the payment according to the set amount of the payment to be processed and the amount of the payment. Specifically, the device determines whether the compensation amount of the set is greater than or equal to the pending payment of the set. The amount of compensation, if the amount of the payment of the set is greater than or equal to the amount of the pending payment of the set, the amount of the pending payment of the set is used as the amount of the payment of the set; if the amount of the payment of the set is less than the amount of the pending payment of the set, The set of claims limits is the amount of the set's payout.
  • the annotation generating device of the bill should annotate the origin and the basis of the payment amount of the collection, and the annotation information may be “the payment amount of the category A medicine is 3,000 yuan.
  • the A-type drug in the bill is 3,500 yuan, and the amount of the A-type drug in the bill is greater than the amount of the claim, so the claim amount of the A-type drug in the bill is 3,000 yuan, thus playing the role of reminding the user, avoiding the user accounting result and device accounting.
  • the results are inconsistent, and consulting with customer service has led to the problem of increasing the length of bill claims.
  • the device After determining the payout amount of each set, the device superimposes the payout amount of each set, thereby obtaining the payout amount of the user bill.
  • the bill generating means determines the paying type of the paying object after determining the paying object in the user bill, so that each paying object is classified into a plurality of sets according to the paying type, and then determined according to the paying type. And determining a to-be-paid amount of the collection according to the compensation amount of the compensation object, thereby determining the payment amount of the collection according to the collective compensation amount and the to-be-paid compensation amount, thereby determining the payment amount of the user bill according to the compensation amount of each set;
  • the bill generating device enables the bill to accurately calculate the amount of the user's bill.
  • the present application also provides an annotation generating apparatus for billing, the bill generating apparatus of the bill comprising a processor, a memory, and an annotation generating program of a bill stored on the memory and executable on the processor, the billing
  • the annotation generation program is executed by the processor to implement the steps of the bill generation method of the bill as described in the above embodiment.
  • the present application also provides a computer readable storage medium storing an annotation generating program of a bill, the bill generating program of the bill being executed by the processor to implement the bill as described in the above embodiment The steps to the annotation generation method.
  • the technical solution of the present application which is essential or contributes to the prior art, may be embodied in the form of a software product stored in a storage medium (such as ROM/RAM as described above). , a disk, an optical disk, including a number of instructions for causing a terminal device (which may be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.) to perform the methods described in the various embodiments of the present application.
  • a terminal device which may be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.

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Abstract

本申请公开了一种账单的注释生成方法,所述账单的注释生成方法包括以下步骤:在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;输出所述用户账单的赔付金额以及所述赔付金额的注释信息。本申请还公开了一种账单的注释生成装置和计算机可读存储介质。本申请提高了账单的理赔效率。

Description

账单的注释生成方法、装置和计算机可读存储介质
本申请要求于2018年02月26日提交中国专利局、申请号为201810160324.X、发明名称为“账单的注释生成方法、装置和计算机可读存储介质”的中国专利申请的优先权,其全部内容通过引用结合在申请中。
技术领域
本申请涉及通信技术领域,尤其涉及一种账单的注释生成方法、装置和计算机可读存储介质。
背景技术
随着人们生活水平的提高,越来越多的人有能力购买保险以降低意外事故的损失。
在购买保险的用户拿到理赔账单后,由于用户不能确定理赔账单的理赔金额是否合理,从而用户会向客服咨询,增长了整个理赔流程时长,即账单的理赔效率低。
发明内容
本申请的主要目的在于提供一种账单的注释生成方法、装置和计算机可读存储介质,旨在账单的理赔效率低的问题。
为实现上述目的,本申请提供一种账单的注释生成方法,所述账单的注释生成方法包括以下步骤:
在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;
获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;
根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;
输出所述用户账单的赔付金额以及所述赔付金额的注释信息。
优选地,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤包括:
根据所述理赔产品信息确定所述赔付金额对应的计算方式以及计算依据;
根据所述计算依据以及所述计算方式生成所述赔付金额的注释信息。
优选地,所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤包括:
根据所述理赔产品信息确定所述用户账单中的各个赔付对象;
确定各个所述赔付对象的赔付金额,并根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额。
优选地,所述根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额的步骤包括:
确定各个所述赔付对象的赔付类型,并聚合相同赔付类型的所述赔付对象得到多个集合;
根据各个所述赔付对象的赔付金额计算各个所述集合的待处理赔付金额;
根据所述理赔产品信息确定各个所述赔付类型对应的赔付额度,并将所述赔付类型对应的赔付额度作为所述赔付类型对应的所述集合的赔付额度;
根据所述集合的赔付额度及其待处理赔付金额确定所述集合的赔付金额,并叠加各个所述集合的赔付金额得到所述账单的赔付金额。
优选地,所述根据所述集合的赔付额度及其金额确定所述集合的赔付金额的步骤包括:
判断所述集合的赔付额度是否大于或等于所述集合的待处理赔付金额;
在所述集合的赔付额度大于或等于所述集合的待处理赔付金额,将所述集合的待处理赔付金额作为所述集合的赔付金额;
在所述集合的赔付额度小于所述集合的待处理赔付金额时,将所述集合的赔付额度作为所述集合的赔付金额。
优选地,所述获取用户信息关联的理赔产品信息的步骤之后,还包括:
根据所述理赔产品信息获取理赔产品的有效期限,并获取所述用户账单中的账单生成时间点;
判断所述账单生成时间点是否处于所述有效期限;
在所述账单生成时间点处于所述有效期限时,执行所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤。
优选地,所述判断所述账单生成时间点是否处于所述有效期限的步骤之后,还包括:
在所述账单生成时间点未处于所述有效期限时,生成并输出拒赔信息。
优选地,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤之后,还包括:
根据所述理赔产品信息确定所述用户账单中的非赔付对象;
生成所述非赔付对象对应的注释信息,并输出所述用户账单的赔付金额、所述用户账单的赔付金额对应的注释信息、所述非赔付对象以及所述非赔付对象对应的注释信息,其中,所述非赔付对象的注释信息包括非赔付对象的拒赔原因。
为实现上述目的,本申请还提供一种账单的注释生成装置,所述账单的注释生成装置包括处理器、存储器以及存储在所述存储器上并可在所述处理器上运行的账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现如上所述的账单的注释生成方法的步骤。
为实现上述目的,本申请还提供一种计算机可读存储介质,所述计算机可读存储介质存储有账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现如上所述的账单的注释生成方法的步骤。
本申请提供一种账单的注释生成方法、装置和计算机可读存储介质,账单的注释生成装置在接收到账单理算请求时,根据该请求获取用户账单以及用户信息,然后获取用户信息关联的理赔产品信息,再根据理赔产品信息确定用户账单的赔付金额,并根据理赔产品信息生成赔付金额对应的注释信息,最后输出用户账单的赔付金额以及赔付金额的注释信息;因账单的注释生成装置能够输出用户账单的赔付金额以及赔付金额的注释信息,使得用户能够根据注释信息得到赔付金额的计算方式以及计算依据,从而减少用户对账单的疑惑,避免用户向客服询问导致账单理赔时长增长的问题,提高了账单的理赔效率。
附图说明
图1为本申请实施例所涉及的账单的注释生成装置的硬件结构示意图;
图2为本申请账单的注释生成方法的第一实施例的流程示意图;
图3为图2中步骤S200中根据所述理赔产品信息确定所述用户账单的赔付金额的细化流程示意图;
图4为图2中步骤S300的细化流程示意图;
图5为本申请账单的注释生成方法的第二实施例的流程示意图。
本申请目的的实现、功能特点及优点将结合实施例,参照附图做进一步说明。
具体实施方式
应当理解,此处所描述的具体实施例仅仅用以解释本申请,并不用于限定本申请。
本申请实施例的主要解决方案是:在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;输出所述用户账单的赔付金额以及所述赔付金额的注释信息。
由于现有技术中,在购买保险的用户拿到理赔账单后,不能确定理赔账单的理赔金额是否合理,从而使得用户向客服咨询,增长了整个理赔流程时长,即账单的理赔效率低。
本申请提供一种解决方案,因账单的注释生成装置能够输出用户账单的赔付金额以及赔付金额的注释信息,使得用户能够根据注释信息得到赔付金额的计算方式以及计算依据,从而减少用户对账单的疑惑,避免用户向客服询问导致账单理赔时长增长的问题,提高了账单的理赔效率。
作为一种实现方案,本申请实施例所涉及的账单的注释生成装置的硬件结构示意图可以如图1所示。
参照图1,该账单的注释生成装置可以包括:处理器1001,例如CPU,存储器1002,通信总线1003。其中,通信总线1003用于实现该账单的注释生成装置中各组成部件之间的连接通信。存储器1002可以是高速RAM存储器,也可以是稳定的存储器(non-volatile memory),例如磁盘存储器。存储器1002可选的还可以是独立于前述处理器1001的存储装置。如图1所示,作为一种计算机存储介质的存储器1002中可以包括账单的注释生成程序。在图1所示的账单的注释生成装置所涉及的硬件中,处理器1001可以用于调用存储器1002中存储的账单的注释生成程序,并执行以下各实施例中账单的注释生成方法的各个步骤。
本实施例根据上述方案,账单的注释生成装置在接收到账单理算请求时,根据该请求获取用户账单以及用户信息,然后获取用户信息关联的理赔产品信息,再根据理赔产品信息确定用户账单的赔付金额,并根据理赔产品信息生成赔付金额对应的注释信息,最后输出用户账单的赔付金额以及赔付金额的注释信息;因账单的注释生成装置能够输出用户账单的赔付金额以及赔付金额的注释信息,使得用户能够根据注释信息得到赔付金额的计算方式以及计算依据,从而减少用户对账单的疑惑,避免用户向客服询问导致账单理赔时长增长的问题,提高了账单的理赔效率。
基于上述硬件构架,提出本申请账单的注释生成方法的实施例。
参照图2,图2为本申请账单的注释生成方法的第一实施例,所述账单的注释生成方法包括以下步骤:
步骤S100,在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;
在本申请中,执行主体为账单的注释生成装置。在当用户需要理赔时,用户可通过与理赔账单的注释生成装置关联的APP将需要理赔的账单的上传至账单的注释生成装置,也即用户可通过APP向账单的注释生成装置发送账单理算请求,账单理算请求中含有用户账单;用户账单上含有用户的名称,账单的注释生成装置可以根据用户的名称获取对应的用户信息。当然,用户账单上需盖有生成该用户账单的单位公章,也即账单的注释生成装置需判断用户账单是否含有单位公章。
需要说明的是,账单的注释生成装置在获取用户账单以及用户信息后,或确定用户账单的类型,并根据用户信息确定用户购买的理赔产品的类型,进一步,判断用户账单的类型是否与理赔产品的类型是否一致,比如,用户账单为住院账单,而用户购买的理赔产品为车险,那么,用户上传的用户账单与理赔产品并不匹配,此时,账单的注释生成装置会输出用户账单类型错误的提示信息,以提醒用户上传正确的用户账单。
步骤S200,获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;
在账单的注释生成装置获取用户信息后,根据用户信息确定该用户购买的理赔产品,从而获得对应的理赔产品信息,然后根据理赔产品信息确定用户账单的赔付金额,具体的,请参照图3,即步骤S200中根据所述理赔产品信息确定所述用户账单的赔付金额的步骤包括:
步骤S210,根据所述理赔产品信息确定所述用户账单中的各个赔付对象;
理赔产品信息包括可赔付的对象,比如,用户购买的理赔产品为健康险时,可对住院中的药品进行报销,而健康险的具有多个类型,每一种类型的健康险赔付不同药品,比如高等级的健康险可赔付A、B以及C类三类药品,A、B、C类三类药品可按照价格进行区分,例如,将处于0-200元的药品作为A类药品,将处于200-500元的药品作为B类药品,将处于500-800元的药品作为C类产品,当然,A、B、C类三类药品还可按照药品类型进行区分;用户账单内含有各个药品对应的金额,账单的注释生成装置可根据药品的金额确定该药品的类别,若药品为A、B、C类药品中的任一类,该药品即为用户账单中的赔付对象。
步骤S220,确定各个所述赔付对象的赔付金额,并叠加各个所述赔付对象的赔付金额得到所述用户账单的赔付金额;
账单的注释生成装置在确定用户账单中的各个赔付对象后,可以叠加各个赔付对象的赔付金额得到用户账单的赔付金额。
需要说明的是,在获取理赔产品信息后,装置根据理赔产品信息确定用户购买的理赔产品的有效期限,然后在用户账单中获取账单生成时间点,再判断账单生成时间点是否处于理赔产品的有效期限内,若账单生成时间点处于理赔产品的有效期限内,则进行下一步骤;若账单生成时间点未处于理赔产品的有效期限,生成并输出拒赔信息,拒赔信息可以拒赔的具体理由,比如,账单过期的提示信息。
步骤S300,根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;
在当账单的注释生成装置确定用户账单的赔付金额后,账单的注释生成装置会进一步生成与赔付金额对应的注释信息,注释信息为赔付金额的计算方法以及赔付金额的计算依据等,具体的,请参照图4,即步骤S300包括:
步骤S310,根据所述理赔产品信息确定所述赔付金额对应的计算方式以及计算依据;
账单的赔付金额由账单的各个赔付对象的赔付金额确定。在当账单的注释生成装置在确定赔付金额后,确定各个赔付对象的计算依据以及赔付金额,然后,叠加各个赔付对象的赔付金额从而获得赔付金额的计算公式(计算方式)。
步骤S320,根据所述计算依据以及所述计算方式生成所述赔付金额的注释信息;
账单的注释生成装置在确定赔付金额的计算依据以及计算方式后,生成该赔付金额的注释信息。具体的,装置在判定账单内的各个赔付对象时,生成赔付对象的判定理由,比如,赔付对象为药品“葡萄糖”,葡萄糖属于A类药品,该赔付对象的判定理由为:“葡萄糖为20元,属于价格0-200元之间的A类药品,属于可赔付药品”,也即账单的赔付金额对应的计算依据由各个赔付对象的判定理由构成;装置在确定账单的各个赔付对象后,将各个赔付对象的金额叠加从而获得账单的赔付金额,并且生成叠加公式,该叠加公式即为赔付金额对应的计算方式;可以理解的是,账单的赔付金额的注释信息由账单的各个赔付对象对应的判定理由以及各个赔付对象对应的金额的叠加公式组成。
进一步的,账单的注释生成装置在生成赔付金额的注释信息后,可调取理赔产品信息,在理赔产品信息中获取用户购买的理赔产品,从而将用户可赔付的类型进行注释(注释可为“用户A可赔付A类药品”),或者,账单的注释生成装置可将理赔产品合同中用户购买的赔付类别进行注释(注释可为“用户A购买的赔付类型为A类药品”),或者直接输出用户的理赔产品合同,进一步减少用户的疑惑。
步骤S400,输出所述用户账单的赔付金额以及所述赔付金额的注释信息;
在账单的注释生成装置生成赔付金额对应的注释信息后,输出赔付金额以及赔付金额对应的注释信息,使得用户可以根据注释信息明确得知用户账单的理赔规则,以减少用户的疑惑。
进一步的,账单注释生成装置可根据理赔产品信息确定用户信息中的非赔付对象,确定用户账单中的非赔付对象与确定用户账单的赔付对象的原理相同,在此不再一一赘述;然后,装置生成非赔付对象的注释信息,比如,非赔付对象为药品葡萄糖,注释信息为“葡萄糖为A类药品,不属于理赔产品的赔付对象”(非赔付对象的注释信息为非赔付对象的拒赔原因),最后,装置将非赔付对象、非赔付对象的注释信息、用户账单的赔付金额、赔付金额的注释信息一同输出。
本实施例提供的技术方案中,账单的注释生成装置在接收到账单理算请求时,根据该请求获取用户账单以及用户信息,然后获取用户信息关联的理赔产品信息,再根据理赔产品信息确定用户账单的赔付金额,并根据理赔产品信息生成赔付金额对应的注释信息,最后输出用户账单的赔付金额以及赔付金额的注释信息;因账单的注释生成装置能够输出用户账单的赔付金额以及赔付金额的注释信息,使得用户能够根据注释信息得到赔付金额的计算方式以及计算依据,从而减少用户对账单的疑惑,避免用户向客服询问导致账单理赔时长增长的问题,提高了账单的理赔效率。
参照图5,图5为本申请账单注释生成方法的第二实施例,基于上述实施例,所述步骤S210中根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额的步骤包括:
步骤S211,确定各个所述赔付对象的赔付类型,并聚合相同赔付类型的所述赔付对象得到多个集合;
账单的注释生成装置在根据理赔产品信息确定用户账单中的赔付对象之前,首先需要确定用户账单内各个对象的类型,然后根据理赔产品信息确定赔付类型,若用户账单内对象的类型为赔付类型时,该对象即为赔付对象,也即账单的注释生成装置在确定赔付对象时,也会同时确定赔付对象对应的赔付类型。在确定各个赔付对象的赔付类型时,将相同赔付类型的赔付对象聚合,从而得到多个集合,每一个集合对应一种赔付类型。
步骤S212,根据各个所述赔付对象的赔付金额计算各个所述集合的待处理赔付金额;
装置在确定集合内的各个赔付对象的赔付金额后,叠加该集合的各个赔付对象的赔付金额,从而获得该集合的待处理赔付金额,以此类推,装置可确定各个集合的待处理赔付金额。步骤S213,根据所述理赔产品信息确定各个所述赔付类型对应的赔付额度,并将所述赔付类型对应的赔付额度作为所述赔付类型对应的所述集合的赔付额度;
理赔产品中的赔付类型具有对应的赔付额度,如,A类产品的赔付额度为3000元;装置可将赔付类型对应的赔付额度作为该类型对应的集合的赔付额度。
步骤S214,根据所述集合的赔付额度及其待处理赔付金额确定所述集合的赔付金额,并根据各个所述集合的赔付金额确定所述账单的赔付金额;
装置在确定集合的待处理赔付金额以及赔付额度后,装置会根据集合的待处理赔付金额以及赔付额度确定集合的赔付金额,具体的,装置判断集合的赔付额度是否大于或等于该集合的待处理赔付金额,若集合的赔付额度大于或等于该集合的待处理赔付金额,则将集合的待处理赔付金额作为该集合的赔付金额;若集合的赔付额度小于该集合的待处理赔付金额,则将集合的赔付额度作为该集合的赔付金额。需要说明的是,在当集合的赔付额度小于该集合的待处理赔付金额,账单的注释生成装置应注释集合的赔付金额的由来以及依据,注释信息可为“A类药品的赔付额度为3000元,账单中A类药品为3500元,账单中A类药品赔付金额大于赔付额度,故账单中A类药品的理赔金额为3000元”,从而起到提醒用户的作用,避免用户核算结果与装置核算结果不一致,向客服咨询,导致账单理赔时长增长的问题。
装置在确定各个集合的赔付金额后,将各个集合的赔付金额叠加,从而获得用户账单的赔付金额。
本实施例提供的技术方案中,账单的注释生成装置在确定用户账单中的赔付对象后,确定赔付对象的赔付类型,从而根据赔付类型将各个赔付对象分类得到多个集合,再根据赔付类型确定集合的赔付额度并根据赔付对象的赔付金额确定集合的待处理赔付金额,由此根据集合赔付额度以及待处理赔付金额确定集合的赔付金额,从而根据各个集合的赔付金额确定用户账单的赔付金额;使得账单的注释生成装置能够精准的计算用户账单的赔付金额,
本申请还提供一种账单的注释生成装置,所述账单的注释生成装置包括处理器、存储器以及存储在所述存储器上并可在所述处理器上运行的账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现如上实施例所述的账单的注释生成方法的步骤。
本申请还提供一种计算机可读存储介质,所述计算机可读存储介质存储有账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现如上实施例所述的账单的注释生成方法的步骤。
上述本申请实施例序号仅仅为了描述,不代表实施例的优劣。
需要说明的是,在本文中,术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含,从而使得包括一系列要素的过程、方法、物品或者装置不仅包括那些要素,而且还包括没有明确列出的其他要素,或者是还包括为这种过程、方法、物品或者装置所固有的要素。在没有更多限制的情况下,由语句“包括一个……”限定的要素,并不排除在包括该要素的过程、方法、物品或者装置中还存在另外的相同要素。
通过以上的实施方式的描述,本领域的技术人员可以清楚地了解到上述实施例方法可借助软件加必需的通用硬件平台的方式来实现,当然也可以通过硬件,但很多情况下前者是更佳的实施方式。基于这样的理解,本申请的技术方案本质上或者说对现有技术做出贡献的部分可以以软件产品的形式体现出来,该计算机软件产品存储在如上所述的一个存储介质(如ROM/RAM、磁碟、光盘)中,包括若干指令用以使得一台终端设备(可以是手机,计算机,服务器,空调器,或者网络设备等)执行本申请各个实施例所述的方法。
以上仅为本申请的优选实施例,并非因此限制本申请的专利范围,凡是利用本申请说明书及附图内容所作的等效结构或等效流程变换,或直接或间接运用在其他相关的技术领域,均同理包括在本申请的专利保护范围内。

Claims (20)

  1. 一种账单的注释生成方法,其特征在于,所述账单的注释生成方法包括:
    在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;
    获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;
    根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;
    输出所述用户账单的赔付金额以及所述赔付金额的注释信息。
  2. 如权利要求1所述的账单的注释生成方法,其特征在于,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤包括:
    根据所述理赔产品信息确定所述赔付金额对应的计算方式以及计算依据;
    根据所述计算依据以及所述计算方式生成所述赔付金额的注释信息。
  3. 如权利要求1所述的账单的注释生成方法,其特征在于,所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤包括:
    根据所述理赔产品信息确定所述用户账单中的各个赔付对象;
    确定各个所述赔付对象的赔付金额,并根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额。
  4. 如权利要求3所述的账单的注释生成方法,其特征在于,所述根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额的步骤包括:
    确定各个所述赔付对象的赔付类型,并聚合相同赔付类型的所述赔付对象得到多个集合;
    根据各个所述赔付对象的赔付金额计算各个所述集合的待处理赔付金额;
    根据所述理赔产品信息确定各个所述赔付类型对应的赔付额度,并将所述赔付类型对应的赔付额度作为所述赔付类型对应的所述集合的赔付额度;
    根据所述集合的赔付额度及其待处理赔付金额确定所述集合的赔付金额,并叠加各个所述集合的赔付金额得到所述账单的赔付金额。
  5. 如权利要求4所述的账单的注释生成方法,其特征在于,所述根据所述集合的赔付额度及其金额确定所述集合的赔付金额的步骤包括:
    判断所述集合的赔付额度是否大于或等于所述集合的待处理赔付金额;
    在所述集合的赔付额度大于或等于所述集合的待处理赔付金额,将所述集合的待处理赔付金额作为所述集合的赔付金额;
    在所述集合的赔付额度小于所述集合的待处理赔付金额时,将所述集合的赔付额度作为所述集合的赔付金额。
  6. 如权利要求1所述的账单的注释生成方法,其特征在于,所述获取用户信息关联的理赔产品信息的步骤之后,还包括:
    根据所述理赔产品信息获取理赔产品的有效期限,并获取所述用户账单中的账单生成时间点;
    判断所述账单生成时间点是否处于所述有效期限;
    在所述账单生成时间点处于所述有效期限时,执行所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤。
  7. 如权利要求6所述的账单的注释生成方法,其特征在于,所述判断所述账单生成时间点是否处于所述有效期限的步骤之后,还包括:
    在所述账单生成时间点未处于所述有效期限时,生成并输出拒赔信息。
  8. 如权利要求1所述的账单的注释生成方法,其特征在于,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤之后,还包括:
    根据所述理赔产品信息确定所述用户账单中的非赔付对象;
    生成所述非赔付对象对应的注释信息,并输出所述用户账单的赔付金额、所述用户账单的赔付金额对应的注释信息、所述非赔付对象以及所述非赔付对象对应的注释信息,其中,所述非赔付对象的注释信息包括非赔付对象的拒赔原因。
  9. 一种账单的注释生成装置,其特征在于,所述账单的注释生成装置包括处理器、存储器以及存储在所述存储器上并可在所述处理器上运行的账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现以下步骤:
    在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;
    获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;
    根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;
    输出所述用户账单的赔付金额以及所述赔付金额的注释信息。
  10. 如权利要求9所述的账单的注释生成装置,其特征在于,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤包括:
    根据所述理赔产品信息确定所述赔付金额对应的计算方式以及计算依据;
    根据所述计算依据以及所述计算方式生成所述赔付金额的注释信息。
  11. 如权利要求9所述的账单的注释生成装置,其特征在于,所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤包括:
    根据所述理赔产品信息确定所述用户账单中的各个赔付对象;
    确定各个所述赔付对象的赔付金额,并根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额。
  12. 如权利要求11所述的账单的注释生成装置,其特征在于,所述根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额的步骤包括:
    确定各个所述赔付对象的赔付类型,并聚合相同赔付类型的所述赔付对象得到多个集合;
    根据各个所述赔付对象的赔付金额计算各个所述集合的待处理赔付金额;
    根据所述理赔产品信息确定各个所述赔付类型对应的赔付额度,并将所述赔付类型对应的赔付额度作为所述赔付类型对应的所述集合的赔付额度;
    根据所述集合的赔付额度及其待处理赔付金额确定所述集合的赔付金额,并叠加各个所述集合的赔付金额得到所述账单的赔付金额。
  13. 如权利要求12所述的账单的注释生成装置,其特征在于,所述根据所述集合的赔付额度及其金额确定所述集合的赔付金额的步骤包括:
    判断所述集合的赔付额度是否大于或等于所述集合的待处理赔付金额;
    在所述集合的赔付额度大于或等于所述集合的待处理赔付金额,将所述集合的待处理赔付金额作为所述集合的赔付金额;
    在所述集合的赔付额度小于所述集合的待处理赔付金额时,将所述集合的赔付额度作为所述集合的赔付金额。
  14. 如权利要求9所述的账单的注释生成装置,其特征在于,所述获取用户信息关联的理赔产品信息的步骤之后,所述账单的注释生成程序被所述处理器执行时实现以下步骤:
    根据所述理赔产品信息获取理赔产品的有效期限,并获取所述用户账单中的账单生成时间点;
    判断所述账单生成时间点是否处于所述有效期限;
    在所述账单生成时间点处于所述有效期限时,执行所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤。
  15. 如权利要求14所述的账单的注释生成装置,其特征在于,所述判断所述账单生成时间点是否处于所述有效期限的步骤之后,所述账单的注释生成程序被所述处理器执行时实现以下步骤:
    在所述账单生成时间点未处于所述有效期限时,生成并输出拒赔信息。
  16. 如权利要求9所述的账单的注释生成装置,其特征在于,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤之后,所述账单的注释生成程序被所述处理器执行时实现以下步骤:
    根据所述理赔产品信息确定所述用户账单中的非赔付对象;
    生成所述非赔付对象对应的注释信息,并输出所述用户账单的赔付金额、所述用户账单的赔付金额对应的注释信息、所述非赔付对象以及所述非赔付对象对应的注释信息,其中,所述非赔付对象的注释信息包括非赔付对象的拒赔原因。
  17. 一种计算机可读存储介质,其特征在于,所述计算机可读存储介质存储有账单的注释生成程序,所述账单的注释生成程序被所述处理器执行时实现以下步骤:
    在接收到账单理算请求时,根据所述账单理算请求获取用户账单以及用户信息;
    获取用户信息关联的理赔产品信息,并根据所述理赔产品信息确定所述用户账单的赔付金额;
    根据所述理赔产品信息生成所述赔付金额对应的注释信息,其中,所述赔付金额的注释信息包括赔付金额的计算方式及/或赔付金额的计算依据;
    输出所述用户账单的赔付金额以及所述赔付金额的注释信息。
  18. 如权利要求17所述的账单的计算机可读存储介质,其特征在于,所述根据所述理赔产品信息生成所述赔付金额对应的注释信息的步骤包括:
    根据所述理赔产品信息确定所述赔付金额对应的计算方式以及计算依据;
    根据所述计算依据以及所述计算方式生成所述赔付金额的注释信息。
  19. 如权利要求17所述的账单的计算机可读存储介质,其特征在于,所述根据所述理赔产品信息确定所述用户账单的赔付金额的步骤包括:
    根据所述理赔产品信息确定所述用户账单中的各个赔付对象;
    确定各个所述赔付对象的赔付金额,并根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额。
  20. 如权利要求19所述的账单的计算机可读存储介质,其特征在于,所述根据各个所述赔付对象的赔付金额确定所述用户账单的赔付金额的步骤包括:
    确定各个所述赔付对象的赔付类型,并聚合相同赔付类型的所述赔付对象得到多个集合;
    根据各个所述赔付对象的赔付金额计算各个所述集合的待处理赔付金额;
    根据所述理赔产品信息确定各个所述赔付类型对应的赔付额度,并将所述赔付类型对应的赔付额度作为所述赔付类型对应的所述集合的赔付额度;
    根据所述集合的赔付额度及其待处理赔付金额确定所述集合的赔付金额,并叠加各个所述集合的赔付金额得到所述账单的赔付金额。
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