1. A method of data processing, comprising:

acquiring a channel identifier for user login and policy information of a user;

generating equity service information and claim settlement service information of the user according to the channel identification and the policy information, wherein the equity service information comprises inquiry and medicine purchasing equity;

and when the user proposes a claim settlement application based on the inquiry medicine purchasing rights, processing the claim settlement application according to the claim settlement service information.

2. The method of claim 1, wherein obtaining channel identification of user login and policy information of user comprises:

responding to a successful login result of the user, and acquiring a login channel of the user and a characteristic identifier of the user;

and inquiring policy information corresponding to the characteristic identifier from a stored policy information base according to the characteristic identifier.

3. The method of claim 1, wherein obtaining channel identification of user login and policy information of user comprises:

receiving a login request sent by a user through a link of a third-party platform, wherein the login request indicates a channel identifier and encrypted policy information logged in by the user;

analyzing an encrypted identifier and a time stamp from the encrypted policy information;

and when the encrypted identification and the timestamp meet preset conditions, acquiring policy information of the user.

4. The method of claim 1, prior to generating equity service information based on the channel identification and the policy information, comprising:

determining that the policy identification of the policy information is not present in a rights and benefits policy table, the rights and benefits policy table including the policy identification of the policy for which rights and benefits service information has been generated;

when the policy identifier of the policy information exists in the rights and interests policy table, determining that the policy corresponding to the policy identifier is a failure policy;

and when the policy corresponding to the policy identification is not the invalid policy, ending the process.

5. The method of claim 1, wherein generating equity service information for a user based on the channel identification and the policy information comprises:

matching the channel identification and the policy information with configured rights and interests service rules through a stream filtering mechanism;

and generating the rights and interests service information of the user according to the matching result.

6. The method of claim 5, wherein the data of the configured entitlement service rules is stored in a database and a Redis cache, the database being synchronized with ES data.

7. The method of claim 5, after generating the equity service information of the user, comprising:

determining the effective time of the equity service information according to the performance time of the policy information;

before the claim application is processed according to the claim service information, the method comprises the following steps: confirming that the inquiry and purchase rights are within the validation time.

8. The method of claim 1, wherein claim settlement service information of the user is generated according to the channel identification and the policy information;

matching the channel identification and the policy information with configured claim settlement service rules through a stream filtering mechanism;

and generating the claim settlement service information of the user according to the matching result.

9. The method of claim 8, wherein the data of the configured claims service rules is stored in a database and a Redis cache, the database synchronized with ES data.

10. The method of claim 1, wherein the claim application indicates drug order information, and the claim service information includes claimable drugs, claim amount, claim times, and accumulated claim information;

processing the claim settlement application according to the claim settlement service information, comprising:

checking the claim settlement quota, the claim settlement times and the accumulated claim settlement information in the claim settlement service information to determine the quota capable of being claimed;

comparing the medicines in the medicine order information with the claimable medicines;

and determining the payable amount corresponding to the medicine order information according to the comparison result and the payable amount.

11. An apparatus for data processing, comprising:

the acquisition module is used for acquiring a channel identifier logged in by a user and policy information of the user;

the service information generating module is used for generating equity service information and claim settlement service information according to the channel identification and the policy information, wherein the equity service information comprises inquiry and medicine purchasing equity;

and the claim settlement module is used for processing the claim settlement application according to the claim settlement service information when the user proposes the claim settlement application based on the inquiry and medicine purchase rights and interests.

12. An electronic device, comprising:

one or more processors;

a storage device for storing one or more programs,

when executed by the one or more processors, cause the one or more processors to implement the method of any one of claims 1-10.

13. A computer-readable medium, on which a computer program is stored, which, when being executed by a processor, carries out the method according to any one of claims 1-10.

Background

With the development of internet technology, the development of insurance business is promoted by the combination of insurance business and the internet, but in the process of insurance claim settlement, due to the fact that medical institutions are involved, the reimbursement of medical expenses needs to be checked manually offline, the period of insurance claim settlement is prolonged, and the claim settlement efficiency is low.

Disclosure of Invention

In view of this, the embodiment of the present invention provides a data processing method, which can generate rights and interests service information according to policy information of a user, and enable the user to apply for online claims settlement according to the inquiry and medicine purchasing rights and interests in the rights and interests service information, so as to improve the claim settlement efficiency and further improve the user experience.

To achieve the above object, according to an aspect of an embodiment of the present invention, there is provided a data processing method including:

acquiring a channel identifier for user login and policy information of a user;

generating equity service information and claim settlement service information of the user according to the channel identification and the policy information, wherein the equity service information comprises inquiry and medicine purchasing equity;

and when the user proposes a claim settlement application based on the inquiry medicine purchasing rights, processing the claim settlement application according to the claim settlement service information.

Optionally, the obtaining of the channel identifier of the user login and the policy information of the user includes:

responding to a successful login result of the user, and acquiring a login channel of the user and a characteristic identifier of the user;

and inquiring policy information corresponding to the characteristic identifier from a stored policy information base according to the characteristic identifier.

Optionally, the obtaining of the channel identifier of the user login and the policy information of the user includes:

receiving a login request sent by a user through a link of a third-party platform, wherein the login request indicates a channel identifier and encrypted policy information logged in by the user;

analyzing an encrypted identifier and a time stamp from the encrypted policy information;

and when the encrypted identification and the timestamp meet preset conditions, acquiring policy information of the user.

Optionally, before generating the equity service information according to the channel identifier and the policy information, the method includes:

determining that the policy identification of the policy information is not present in a rights and benefits policy table, the rights and benefits policy table including the policy identification of the policy for which rights and benefits service information has been generated;

when the policy identifier of the policy information exists in the rights and interests policy table, determining that the policy corresponding to the policy identifier is a failure policy;

and when the policy corresponding to the policy identification is not the invalid policy, ending the process.

Optionally, generating the equity service information of the user according to the channel identifier and the policy information, including:

matching the channel identification and the policy information with configured rights and interests service rules through a stream filtering mechanism;

and generating the rights and interests service information of the user according to the matching result.

Optionally, the data of the configured entitlement service rules is stored in a database and a Redis cache, the database being synchronized with ES data.

Optionally, after generating the equity service information of the user, the method includes:

determining the effective time of the equity service information according to the performance time of the policy information;

before the claim application is processed according to the claim service information, the method comprises the following steps: confirming that the inquiry and purchase rights are within the validation time.

Optionally, generating claim settlement service information of the user according to the channel identifier and the policy information;

matching the channel identification and the policy information with configured claim settlement service rules through a stream filtering mechanism;

and generating the claim settlement service information of the user according to the matching result.

Optionally, the data of the configured claims service rules is stored in a database and a Redis cache, the database being synchronized with ES data.

Optionally, the claim application indicates drug order information, and the claim service information includes claimable drugs, claim amount, claim times and accumulated claim information;

processing the claim settlement application according to the claim settlement service information, comprising:

checking the claim settlement quota, the claim settlement times and the accumulated claim settlement information in the claim settlement service information to determine the quota capable of being claimed;

comparing the medicines in the medicine order information with the claimable medicines;

and determining the payable amount corresponding to the medicine order information according to the comparison result and the payable amount.

According to another aspect of the embodiments of the present invention, there is provided an apparatus for data processing, including:

the acquisition module is used for acquiring a channel identifier logged in by a user and policy information of the user;

the service information generating module is used for generating equity service information and claim settlement service information according to the channel identification and the policy information, wherein the equity service information comprises inquiry and medicine purchasing equity;

and the claim settlement module is used for processing the claim settlement application according to the claim settlement service information when the user proposes the claim settlement application based on the inquiry and medicine purchase rights and interests.

According to another aspect of an embodiment of the present invention, there is provided an electronic apparatus including:

one or more processors;

a storage device 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 data processing method provided by the present invention.

According to a further aspect of the embodiments of the present invention, there is provided a computer-readable medium on which a computer program is stored, the program, when executed by a processor, implementing the method of data processing provided by the present invention.

One embodiment of the above invention has the following advantages or benefits: the rights and interests service information and the claim settlement service information of the user are generated by acquiring the channel identification of the user and the policy information of the user, and when the user puts forward a claim settlement application according to the inquiry medicine purchasing rights in the rights and interests service information, the claim settlement application can be processed according to the claim settlement service information. The embodiment of the invention combines the user policy information with the equity service and the claim settlement service, realizes on-line claim settlement, improves the claim settlement efficiency and further improves the user experience.

Further effects of the above-mentioned non-conventional alternatives will be described below in connection with the embodiments.

Drawings

The drawings are included to provide a better understanding of the invention and are not to be construed as unduly limiting the invention. Wherein:

FIG. 1 is a schematic diagram of a main flow of a method of data processing according to an embodiment of the invention;

FIG. 2 is a schematic diagram of a main flow of another method of data processing according to an embodiment of the invention;

fig. 3 is a schematic main flow chart of generating equity service information according to an embodiment of the present invention;

FIG. 4 is a schematic diagram of an claim settlement process based on the medical benefits of inquiry and purchase according to an embodiment of the present invention;

FIG. 5 is a schematic diagram of the main blocks of a data processing apparatus according to an embodiment of the present invention;

FIG. 6 is an exemplary system architecture diagram in which embodiments of the present invention may be employed;

fig. 7 is a schematic block diagram of a computer system suitable for use in implementing a terminal device or server of an embodiment of the invention.

Detailed Description

Exemplary embodiments of the present invention are described below with reference to the accompanying drawings, in which various details of embodiments of the invention are included to assist understanding, and which are to be considered as merely exemplary. Accordingly, those of ordinary skill in the art will recognize that various changes and modifications of the embodiments described herein can be made without departing from the scope and spirit of the invention. Also, descriptions of well-known functions and constructions are omitted in the following description for clarity and conciseness.

In insurance business, insurance claims occupy an important position, the existing insurance claim mode submits a claim application and submits required data through an insurance company application program, and due to the fact that the insurance claim process also relates to medical institutions, reimbursement of medical expenses is audited under manual lines, the period of the insurance claims is prolonged, and the efficiency of the insurance claims is reduced; in addition, the insurance types of the insurance companies are the same, the competitiveness difference is small, and the difficulty of obtaining customers by the insurance companies through single insurance business is higher and higher; the existing insurance claim settlement method is difficult to be combined with the existing medical health. Therefore, in view of the above problems, embodiments of the present invention provide a method for data processing.

Fig. 1 is a schematic diagram of a main flow of a data processing method according to an embodiment of the present invention, as shown in fig. 1, the method includes the following steps:

step S101: acquiring a channel identifier for user login and policy information of a user;

step S102: generating user's equity service information and claim settlement service information according to the channel identification and policy information, wherein the equity service information comprises inquiry and purchase medicine equity;

step S103: and when the user proposes a claim application based on the inquiry medicine purchasing rights, processing the claim application according to the claim service information.

The data processing method provided by the embodiment of the invention relates to the field of Internet medical treatment and insurance business, and realizes on-line automatic claim settlement by combining Internet medical treatment and insurance claim settlement, so that the insurance claim settlement is more efficient and convenient.

In the embodiment of the invention, the channel identifier is the identifier of the channel logged by the user, the login of the platform can be realized by logging in an application program carrying the platform, the platform can also be logged in by jumping links of other platforms, different login channels correspond to different channel identifiers, and different rights and interests service information and claim settlement service information can be generated by different channel identifiers. For example, a user may log into the platform through a channel such as an Application (APP), a link to an applet or insurance company platform, and so on. When a user logs in the platform, the channel identifier of the user login can be obtained.

In the embodiment of the invention, the policy information of the user can be one or more; the policy information of the user comprises a policy identifier corresponding to the policy information, a characteristic identifier of the user and a user type, wherein the characteristic identifier of the user is a unique identifier corresponding to the user identity and can be information such as an identity number, a mobile phone number and the like of the user; the user type may be a user class, which includes general users who purchase insurance products and premium users who may be insurance brokers or insurance agents who purchase insurance products.

The policy information also includes the insurance kind of the insurance product purchased by the user, the liability information of the insurance product, the information of the applicant, the information of the insured person, the insurance amount, the insurance period, etc. The responsibility information of the insurance product comprises a responsibility identification of the insurance product, the information of the insurant comprises at least one of the name, the identity card number, the mobile phone number, the age, the sex, the marital status and the like of the insurant, and the information of the insurant comprises at least one of the name, the identity card number, the mobile phone number, the age, the sex, the marital status and the like of the insurant. The term of coverage includes the time of effectiveness of the insurance product, etc.

The insurance policy information of the user is the insurance policy information generated by the user after the insurance company or the insurance agency company successfully applies insurance, the insurance company or the insurance agency company can send the insurance policy information of the user to the platform in an encryption butt joint mode, the platform can acquire the insurance policy information of the user in a message queue mode, and further, the insurance policy information sent by the insurance company or the insurance agency company can be monitored and stored, the insurance policy information of the user is stored in the database, and storing the policy identification corresponding to the policy information and the characteristic identification of the user in a Redis cache, and further, due to the fact that the number of the policy information is large, the policy information of the database can be synchronized to an ES (elastic search, a search server based on Lucene) through a binlake cluster (a clustered binary log Binlog collection and subscription service), and the performance of a subsequent policy information query interface is improved.

In an implementation manner of the embodiment of the present invention, acquiring a channel identifier of a user login and policy information of the user includes:

responding to a successful login result of the user, and acquiring a login channel of the user and a characteristic identifier of the user;

and inquiring policy information corresponding to the characteristic identifier from a stored policy information base according to the characteristic identifier.

The user (such as insurance policy user, which can be policyholder or insured) logs in the application program loaded with the platform according to the login information to log in the platform, the login is successful after the login information is verified, and after the user logs in successfully, the login channel identification of the user can be obtained, and the characteristic identification of the user, such as an identification number, according to the characteristic identification of the user, inquiring the policy identification corresponding to the characteristic identification of the user from the stored cache, i.e. matching the user's signature with the user's signature stored in the cache, and, if the matching is successful, that is, if the feature identifiers are consistent, the policy identifier corresponding to the feature identifier of the user can be obtained, and then the policy information corresponding to the policy identifier can be obtained from the database according to the policy identifier. If the corresponding policy identifier is not queried according to the feature identifier of the user, the user may not purchase the insurance product or the insurance company or the insurance agent company may not send the policy information of the user.

In another implementation manner of the embodiment of the present invention, acquiring a channel identifier of a user login and policy information of the user includes:

receiving a login request sent by a user through a link of a third-party platform, wherein the login request indicates a channel identifier and encrypted policy information logged in by the user;

analyzing an encrypted identifier and a time stamp from the encrypted policy information;

and when the encrypted identification and the timestamp meet preset conditions, acquiring policy information of the user.

A user sends a login request to log in a platform through a link of a third-party platform (such as an APP platform of an insurance company or an insurance agency company), wherein the login request comprises login information, such as a user account ID and a password or an authentication code; the login request indicates a channel identifier for the user to login and encrypted policy information, and the encrypted policy information can be obtained by encrypting the policy information by using an encryption Algorithm, and the encryption Algorithm can be one or two of DES (Data encryption Standard) and MD5(Message-Digest Algorithm 5). The encrypted policy information includes an encryption identification and a timestamp, which may be the time at which the encrypted policy information was generated.

Analyzing the encrypted policy information to obtain an encrypted identifier and a timestamp, judging the encrypted identifier and the timestamp, and if the encrypted identifier and the timestamp meet preset conditions, acquiring the policy information of the user; wherein, satisfying the preset condition means: the encrypted identifier analyzed from the encrypted policy information is the same as the preset encrypted identifier, the time difference between the timestamp analyzed from the encrypted policy information and the current time is not more than the preset effective time (for example, the preset effective time is 5 minutes), the policy information is obtained after the verification is passed, and then the service right information can be generated according to the policy information.

In the embodiment of the invention, the policy identification of the policy information sent by the insurance company or the insurance agency company can be the same as the policy identification of the policy information stored in the platform, so as to avoid the condition that the policy identifications corresponding to the policy information of a plurality of insurance companies are the same, after the policy information sent by the insurance company or the insurance agency company is obtained, a unique policy identification is generated for each policy information, and the corresponding relation between the unique policy identification and the policy information is determined.

When a user logs in a platform through an application program, one or more corresponding policy identifications are obtained according to the characteristic identification of the user, each policy identification is judged, whether the policy identification is the policy identification corresponding to the policy which generates the equity service information is judged, if not, the policy identification is a new policy identification, the corresponding equity service information can be generated, and if yes, the corresponding equity service information can not be generated.

Before generating the equity service information, determining that the policy identification of the stored policy information is the unique identification of the policy information, if not, sending an alarm instruction, clearing the policy identification of the policy information in the cache, and updating the policy identification, the user characteristic identification, the channel identification and other information of the policy information in the cache. If so, assembling the policy identification as the policy identification to be performed to generate corresponding rights and interests service information.

In the embodiment of the present invention, before generating the equity service information according to the channel identifier and the policy information, the method includes:

determining that the policy identification of the policy information does not exist in the rights and interests policy table, wherein the rights and interests policy table comprises the policy identification of the policy of which the rights and interests service information is generated;

when the policy identification of the policy information exists in the right policy table, determining the policy corresponding to the policy identification as a failure policy, deleting the policy identification from the right policy table, and then deleting the policy corresponding to the policy identification from the database, so that the policy information regenerates corresponding right service information; and when the policy corresponding to the policy identifier is not a failure policy, ending the process, namely, the policy identifier does not repeatedly generate the equity service information.

In an embodiment of the invention, the equity policy table includes policy identification of policy information for which equity service information has been generated, and the equity policy table may be stored in a Redis cache. After one or more policy identifications of one or more policy information corresponding to the user characteristic identification are obtained, a pin distributed lock is adopted for the policy identification of each policy information to start performing, namely, a process of generating the equity service information by using one policy information is executed each time, whether the policy identification of the policy information exists in an equity policy table is judged at first, if the policy identification does not exist, the policy information corresponding to the policy identification is new policy information, and the corresponding equity service information can be generated according to the policy information corresponding to the policy identification; if the policy information corresponding to the policy identifier is invalid, judging whether the policy information corresponding to the policy identifier is invalid, if not, ending the process, and showing that the policy information corresponding to the policy identifier generates the equity service information, and not repeatedly generating the equity service information, if so, deleting the policy identifier in the equity service table, and deleting the policy information corresponding to the policy identifier from the database, so that the equity service information is regenerated according to the policy identifier, and then the policy identifier is stored in the equity service table.

In the embodiment of the invention, one policy information can generate one-time equity service information, a plurality of policy information can generate a plurality of times of equity service information, the equity in each time of generating equity service information can be the same or different, and the equity can be accumulated, for example, a user can generate the equity of inquiring and purchasing medicines or the equity of physical examination for a plurality of times according to the plurality of policy information.

In the embodiment of the invention, generating the rights and interests service information of the user according to the channel identification and the policy information comprises the following steps: matching the channel identification and the policy information with configured rights and interests service rules through a stream filtering mechanism; and generating the rights and interests service information of the user according to the matching result.

And when the policy identification capable of generating the rights and interests service information is determined, acquiring the policy information corresponding to the policy identification, and generating corresponding rights and interests service information according to the channel identification and the policy information to realize the issuing of the rights and interests. Optionally, the channel identifier and the policy information are matched with the configured equity service rule by means of stream (e.g. jdk1.8 stream) flowing through filter (filtering function) and lambda expression (an anonymous function), and equity service information can be obtained according to the matching result. For example, if the filtering condition is satisfied, yes is returned (true), otherwise no is returned (false), the satisfied equity service rule is filtered, and then equity service information matched with the service rule is acquired, and the feature identifier, the policy identifier and the equity service information of the user are bound, so that the performance is completed, and the issuance of the equity is realized.

In the embodiment of the present invention, the order of the filtering conditions may also be set, for example, the service rule of the policy dimension may be filtered first, and it is determined whether the policy user is the policy user, whether the responsibility identifiers of the insurance products are matched, if not, an alarm is given, whether the premium is matched, then the service rule of the staff dimension may be filtered, if the service objects are matched, whether the types of the applicant and the insured are matched, whether the ages, the sexes, and the marital conditions are matched, and different matching results correspond to different equity service information, and finally, corresponding equity service information may be returned to the user according to the matching results.

In the embodiment of the invention, the equity service information comprises inquiry and purchase medicine equity, and can also comprise family doctors, physical examination, shopping discount and the like, and the inquiry and purchase medicine equity can enable a user to realize claim settlement through video inquiry and medicine purchase and further according to the inquiry and purchase medicine.

For example, matching the user type, the channel identifier and the policy identifier with the configured equity service rule may determine whether the user is an insurance user or a non-insurance user, whether the user type is a normal user or a senior user, whether the channel identifier indicates a platform-mounted application program or an insurance company or an insurance agent company platform, an applet, a wechat public number, and the like, may obtain corresponding policy information through the policy identifier, and obtain information of the user such as age, gender, marital status, insurance amount, insurance product identifier, and the like from the policy information, and the configured equity service rule may be: when the user is judged to be the policy user, issuing inquiry and purchase medicine rights and interests for the user; when the user is a policy user and the user's premium is in the range of 3-5 ten thousand, the user may also be issued a family doctor's interest. When the user is a policy user and the age of the user is more than 50 years old, the user can also be issued with the middle-aged and the elderly physical examination equity, and when the gender of the user is female, the user can be issued with the female physical examination equity.

After the equity service information is generated, the characteristic identification, the policy information and the equity service information of the user are bound and stored in the database, the database and the ES data can be synchronized, and the characteristic identification, the policy identification and the equity service information of the user can be stored in a Redis cache, so that the query efficiency is improved.

In the embodiment of the present invention, after generating the equity service information of the user, the method includes: determining the effective time of the equity service information according to the performance time of the policy information; before processing the claim application according to the claim service information, the method comprises the following steps: confirming the inquiry and medicine purchase rights within the effective time.

The fulfillment time of the policy information is the validation time of the insurance product in the policy information, and the validation time of the equity service information may be the same as the fulfillment time of the policy information, or may be within a preset time period after the fulfillment time. Before processing the claim application of the user according to the claim service information of the user, confirming that the inquiry and medicine purchasing rights are in the effective time, and if the inquiry and medicine purchasing rights are not in the effective time, processing the claim application according to the claim service information.

In the embodiment of the invention, the method for generating the claim settlement service information of the user according to the channel identification and the policy information comprises the following steps: matching the channel identification and the policy information with configured claim settlement service rules through a stream filtering mechanism; and generating the claim settlement service information of the user according to the matching result.

After acquiring the channel identification and the policy information of the user, generating corresponding claim settlement service information, optionally matching the channel identification and the policy information with configured claim settlement service rules by means of stream (such as jdk1.8 stream) flow filter and lambda expression, and acquiring the claim settlement service information according to the matching result, for example, if the filter condition is satisfied, returning yes (true) if the filter condition is satisfied, otherwise returning no (false), filtering out the satisfied service rules, and acquiring the claim settlement service information matched with the claim settlement rules, where the claim settlement service information includes information such as claim amount, claim number, accumulated claim information, claim amount, and the like, and the accumulated claim exemption information includes accumulated claim amount and accumulated claim number.

For example, after the channel identifier is determined, the policy information is matched with the configured claim settlement service rule, a claimable medicine can be determined according to the insurance product responsibility identifier in the policy information, and the claim settlement limit and the claim settlement times can be determined according to the premium and the insurance deadline in the policy information, for example, the claim settlement service information includes daily, monthly and yearly claimable times, the claim settlement limit upper limit and the accumulated claim amount upper limit. For example, when the amount is 5-10 ten thousand yuan, the upper limit of the claim amount can be determined to be 1 ten thousand yuan, the upper limit of the accumulated claim number is 10 times, or the annual accumulated claim amount can be set to be not more than 2 ten thousand yuan, and the annual accumulated claim number is not more than 3 times.

As shown in fig. 2, in the embodiment of the present invention, the claim application indicates drug order information, and the claim service information includes claimable drugs, claim amount, claim times and accumulated claim information;

processing the claim settlement application according to the claim settlement service information, comprising:

step S201: checking the claim settlement quota, the claim settlement times and the accumulated claim settlement information in the claim settlement service information to determine the quota capable of being claimed;

step S202: comparing the medicines in the medicine order information with the claimable medicines;

step S203: and determining the payable amount corresponding to the medicine order information according to the comparison result and the payable amount.

The information of the rights and interests service of the user comprises inquiry and medicine purchasing rights and interests, when the user conducts video inquiry based on the inquiry and medicine purchasing rights and interests, a doctor can make a prescription according to the disease symptoms of the user, then medicine order information can be generated according to the prescription, the user can put forward a claim settlement application based on the inquiry and medicine purchasing rights and interests to obtain the payable amount, wherein the claim settlement application indicates the medicine order information, the medicine order information comprises medicine identification and medicine price, and the amount to be paid can be obtained according to the medicine order information.

When the user applies for claim settlement, the payable amount is determined according to the claim settlement service information. Specifically, when a user applies for claim, the payable medicine, the claim limit, the claim number and the accumulated claim information in the claim service information are checked in real time according to the feature identification and the policy information of the user, the payable limit is determined, the accumulated claim information includes the accumulated claim limit and the accumulated claim number, the claim limit, the claim number and the accumulated claim information are first determined, if the accumulated claim limit of the user reaches the claim limit or the accumulated claim number reaches the claim number, the claim cannot be settled, that is, no payable amount exists, and if the accumulated claim limit does not reach the claim limit and the accumulated claim number does not reach the claim number, the payable limit can be determined.

The method comprises the steps of comparing medicines in the medicine order information with medicines which can be settled, obtaining medicines which can be settled in the medicine order information according to a comparison result, determining the settled amount of the medicines which can be settled and the amount which can be settled, and then obtaining the actual amount to be paid of a user by subtracting the settled amount from the amount to be paid, wherein the amount left by the user to pay the actual amount to be paid is the actual amount to be paid of the user, and the user pays the actual amount to be paid through a payment page to realize the automatic settlement of the inquiry and diagnosis medicine.

In the embodiment of the invention, the data of the configured rights and interests service rule and the data of the configured claims service rule are stored in a database and a Redis cache, and the database is synchronized with ES data. The database can be a Mysql database, and the Mysql database and the ES can be synchronized through binlake, so that the performance of the policy information query interface is improved, and the query efficiency is improved. When a user processes a claim application according to the claim service information, corresponding claim service information is inquired from the database and the Redis cache so as to realize the processing of the claim application.

As shown in fig. 3, which is a schematic diagram of a main process for generating equity service information according to an embodiment of the present invention, when a user purchases an insurance product at an APP of an insurance company or an insurance agent company, policy information is formed, then policy information is obtained in a message queue manner, and is stored in a database, a policy identifier and a feature identifier of the user are stored in a cache, and a policy identifier of the generated equity service information is marked out, when the user successfully logs in through an APP related to internet medical treatment, the feature identifier of the user is obtained based on a user pin, a corresponding policy identifier is queried according to the feature identifier of the user, and it is determined whether a new policy identifier exists, that is, the policy identifier of the equity service information is not generated, and if so, the corresponding policy information is obtained from the database according to the new policy identifier; or, the user connects the login platform through the third party platform, verifies the encrypted policy information, and acquires the policy information after the verification is passed; after obtaining the policy information, starting to perform by using the pin distributed lock, i.e. starting to generate the rights and interests service information, firstly judging whether the policy identification of the policy information exists in the rights and interests policy table, if not, determining that the policy information is the policy to be performed, namely the policy of the right service information to be generated, if the policy exists, whether the policy information corresponding to the policy identification in the right policy table is invalid is judged, if the policy is invalid, deleting the policy identifier from the benefit information table, deleting the original policy information corresponding to the policy identifier from the database, so that the policy information corresponding to the policy identification can generate equity service information, the policy information is determined as the policy to be performed, if the policy is not invalid, the process is ended, ending the process of generating the equity service information by the policy information, skipping, and executing the process of starting performing on the next policy information; then matching the policy to be fulfilled with the configured equity service rule, if the matching is successful, generating corresponding equity service information, and if the matching is failed, removing the policy identification of the policy to be fulfilled from the cache; and then binding the characteristic identification, the policy identification and the rights and interests service information of the user, storing the bound information into a database and a cache, filtering the policy information needing immediate performing, namely determining the effective time of rights and interests according to the performing time of the policy information so as to realize asynchronous batch performing and release pin distributed locks.

As shown in fig. 4, which is a schematic diagram of a claim settlement process based on inquiry medicine purchasing rights according to an embodiment of the present invention, after a user obtains rights and interests service information including the inquiry medicine purchasing rights and interests, a video inquiry is performed based on the inquiry medicine purchasing rights and interests, a doctor makes a prescription, medicine order information is generated, the user proposes a claim settlement application, the claim settlement application indicates the medicine order information, the claim settlement service information is obtained according to a feature identifier and policy information of the user, then, the claimable medicines, the claim settlement amount, the claim settlement times and the accumulated claim settlement information are checked, the payable amount of the present claim is determined, the payable amount of the present claim is subtracted from the payable amount, and the actual amount to be paid by the user in the inquiry medicine purchasing is settled, so that the claim settlement of the inquiry medicine is realized.

The data processing method provided by the embodiment of the invention combines the existing internet medical treatment with insurance claim settlement, and generates corresponding equity service information for the user according to the policy information of the user, so that the user can purchase medicine equity according to inquiry in the equity service information, and a claim settlement application is provided, so as to realize online automatic claim settlement and improve the efficiency of the insurance claim settlement.

As shown in fig. 5, an embodiment of the present invention further provides an apparatus 500 for data processing, including:

the acquiring module 501 acquires a channel identifier for user login and policy information of a user;

a service information generating module 502, configured to generate equity service information and claim settlement service information according to the channel identifier and the policy information, where the equity service information includes inquiry and purchase equity;

and the claim settlement module 503 is configured to process the claim settlement application according to the claim settlement service information when the user proposes the claim settlement application based on the inquiry and medicine purchase rights.

In an implementation manner of the embodiment of the present invention, the obtaining module 501 is further configured to: responding to a successful login result of the user, and acquiring a login channel of the user and a characteristic identifier of the user; and inquiring policy information corresponding to the characteristic identifier from a stored policy information base according to the characteristic identifier.

In another implementation manner of the embodiment of the present invention, the obtaining module 501 is further configured to: receiving a login request sent by a user through a link of a third-party platform, wherein the login request indicates a channel identifier and encrypted policy information logged in by the user; analyzing an encrypted identifier and a time stamp from the encrypted policy information; and when the encrypted identification and the timestamp meet preset conditions, acquiring policy information of the user.

In this embodiment of the present invention, the service information generating module 502 is further configured to: before generating equity service information according to the channel identification and the policy information, the method comprises the following steps: determining whether a policy identification for the policy information exists in a rights and policy table, the rights and policy table including the policy identification for the policy for which rights and service information has been generated. When the policy identifier of the policy information exists in the rights and interests policy table, determining that the policy corresponding to the policy identifier is a failure policy; and when the policy corresponding to the policy identification is not the invalid policy, ending the process.

In an implementation manner of the embodiment of the present invention, the service information generating module 502 is further configured to: matching the channel identification and the policy information with configured rights and interests service rules through a stream filtering mechanism; and generating the rights and interests service information of the user according to the matching result.

In this embodiment of the present invention, the service information generating module 502 is further configured to: after generating the equity service information of the user, determining the effective time of the equity service information according to the fulfillment time of the policy information; confirming that the inquiry and medicine purchasing rights are in the effective time before processing the claim application according to the claim service information.

In an implementation manner of the embodiment of the present invention, the service information generating module 502 is further configured to: matching the channel identification and the policy information with configured claim settlement service rules through a stream filtering mechanism; and generating the claim settlement service information of the user according to the matching result.

In this embodiment of the present invention, the claim settlement module 503 is further configured to: checking the claim settlement quota, the claim settlement times and the accumulated claim settlement information in the claim settlement service information to determine the quota capable of being claimed; comparing the medicines in the medicine order information with the claimable medicines; and determining the payable amount corresponding to the medicine order information according to the comparison result and the payable amount.

The data processing device provided by the embodiment of the invention can be a platform on an application program, such as a health insurance service platform. The platform can be logged in through an application program, or can be logged in through a link in an insurance company or an insurance agency company, the platform is in butt joint with the insurance company or the insurance agency company, and is also in butt joint with an application program, an applet and the like related to internet medical treatment, and meanwhile, an insurance link of the insurance company or the insurance agency company can be added on the application program, so that a user can jump to an insurance product insurance page through the insurance link, pre-purchase and insurance application of the insurance product are realized, and mutual drainage of the internet medical health field and the insurance field is realized.

According to the data processing device, the acquisition module is used for acquiring the login channel identification of the user and the policy information of the user, and the service information generation module is used for generating the equity service information and the claim settlement service information, so that when the user proposes the claim settlement things according to the equity in the service equity information, the claim settlement application processed by the claim settlement module is used for realizing automatic claim settlement, the data processing device can realize the combination of internet medical treatment and insurance claim settlement, the claim settlement efficiency is improved, and the user experience is further improved.

An embodiment of the present invention further provides an electronic device, including: one or more processors; the storage device is used for storing one or more programs, and when the one or more programs are executed by one or more processors, the one or more processors realize the data processing method provided by the invention.

According to a further aspect of the embodiments of the present invention, there is provided a computer-readable medium on which a computer program is stored, the program, when executed by a processor, implementing the method of data processing provided by the present invention.

Fig. 6 shows an exemplary system architecture 600 of a data processing apparatus or a method of data processing to which embodiments of the invention may be applied.

As shown in fig. 6, the system architecture 600 may include terminal devices 601, 602, 603, a network 604, and a server 605. The network 604 serves to provide a medium for communication links between the terminal devices 601, 602, 603 and the server 605. Network 604 may include various types of connections, such as wire, wireless communication links, or fiber optic cables, to name a few.

A user may use the terminal devices 601, 602, 603 to interact with the server 605 via the network 604 to receive or send messages or the like. The terminal devices 601, 602, 603 may have installed thereon various communication client applications, such as a health insurance service platform, a shopping-like application, a web browser application, a search-like application, an instant messaging tool, a mailbox client, social platform software, etc. (by way of example only).

The terminal devices 601, 602, 603 may be various electronic devices having a display screen and supporting web browsing, including but not limited to smart phones, tablet computers, laptop portable computers, desktop computers, and the like.

Server 605 may be a server that provides various services, such as a back-office management server (for example only) that provides support for health insurance services viewed by users using terminal devices 601, 602, 603. The background management server may analyze and process the received data such as the claim settlement application, and feed back a processing result (for example, a payable amount — just an example) to the terminal device.

It should be noted that the data processing method provided by the embodiment of the present invention is generally executed by the server 605, and accordingly, the data processing apparatus is generally disposed in the server 605.

It should be understood that the number of terminal devices, networks, and servers in fig. 6 is merely illustrative. There may be any number of terminal devices, networks, and servers, as desired for implementation.

Referring now to FIG. 7, shown is a block diagram of a computer system 700 suitable for use with a terminal device implementing an embodiment of the present invention. The terminal device shown in fig. 7 is only an example, and should not bring any limitation to the functions and the scope of use of the embodiments of the present invention.

As shown in fig. 7, the computer system 700 includes a Central Processing Unit (CPU)701, which can perform various appropriate actions and processes in accordance with a program stored in a Read Only Memory (ROM)702 or a program loaded from a storage section 708 into a Random Access Memory (RAM) 703. In the RAM 703, various programs and data necessary for the operation of the system 700 are also stored. The CPU 701, the ROM 702, and the RAM 703 are connected to each other via a bus 704. An input/output (I/O) interface 705 is also connected to bus 704.

The following components are connected to the I/O interface 705: an input portion 706 including a keyboard, a mouse, and the like; an output section 707 including a display such as a Cathode Ray Tube (CRT), a Liquid Crystal Display (LCD), and the like, and a speaker; a storage section 708 including a hard disk and the like; and a communication section 709 including a network interface card such as a LAN card, a modem, or the like. The communication section 709 performs communication processing via a network such as the internet. A drive 710 is also connected to the I/O interface 705 as needed. A removable medium 711 such as a magnetic disk, an optical disk, a magneto-optical disk, a semiconductor memory, or the like is mounted on the drive 710 as necessary, so that a computer program read out therefrom is mounted into the storage section 708 as necessary.

In particular, according to the embodiments of the present disclosure, the processes described above with reference to the flowcharts may be implemented as computer software programs. For example, embodiments of the present disclosure include a computer program product comprising a computer program embodied on a computer readable medium, the computer program comprising program code for performing the method illustrated in the flow chart. In such an embodiment, the computer program can be downloaded and installed from a network through the communication section 709, and/or installed from the removable medium 711. The computer program performs the above-described functions defined in the system of the present invention when executed by the Central Processing Unit (CPU) 701.

It should be noted that the computer readable medium shown in the present invention can be a computer readable signal medium or a computer readable storage medium or any combination of the two. A computer 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 of the computer readable storage medium may include, but are not limited to: an electrical connection having one or more wires, a portable computer diskette, 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. In the present invention, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device. In the present invention, however, a computer readable signal medium may include a propagated data signal with computer 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 computer readable signal medium may also be any computer readable medium that is not a computer 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 computer readable medium may be transmitted using any appropriate medium, including but not limited to: wireless, wire, fiber optic cable, RF, etc., or any suitable combination of the foregoing.

The flowchart and block diagrams in the figures illustrate the architecture, functionality, and operation of possible implementations of systems, methods and computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of code, which comprises one or more executable instructions for implementing the specified logical function(s). It should also be noted that, in some alternative implementations, the functions noted in the block may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It will also be noted that each block of the block diagrams or flowchart illustration, and combinations of blocks in the block diagrams or flowchart illustration, can be implemented by special purpose hardware-based systems which perform the specified functions or acts, or combinations of special purpose hardware and computer instructions.

The modules described in the embodiments of the present invention may be implemented by software or hardware. The described modules may also be provided in a processor, which may be described as: a processor comprises an acquisition module, a service information generation module and a claim settlement module. The names of these modules do not constitute a limitation to the module itself in some cases, for example, the obtaining module may also be described as a module for obtaining the channel identification of the user login and the policy information of the user.

As another aspect, the present invention also provides a computer-readable medium that may be contained in the apparatus described in the above embodiments; or may be separate and not incorporated into the device. The computer readable medium carries one or more programs which, when executed by a device, cause the device to comprise: acquiring a channel identifier for user login and policy information of a user; generating user's equity service information and claim settlement service information according to the channel identification and policy information, wherein the equity service information comprises inquiry and purchase medicine equity; and when the user proposes a claim application based on the inquiry medicine purchasing rights, processing the claim application according to the claim service information.

According to the technical scheme of the embodiment of the invention, the rights and interests service information and the claim settlement service information of the user are generated by acquiring the channel identification and the policy information logged in by the user, so that when the user puts forward a claim settlement application based on the rights and interests in the rights and interests service information, the claim settlement application is processed according to the claim settlement service information, and automatic claim settlement is realized. The data processing method provided by the embodiment of the invention combines the existing internet medical treatment with insurance claim settlement, and generates corresponding equity service information for the user according to the policy information of the user, so that the user can purchase medicine equity according to inquiry in the equity service information, and a claim settlement application is provided, so as to realize online automatic claim settlement and improve the efficiency of the insurance claim settlement.

The above-described embodiments should not be construed as limiting the scope of the invention. Those skilled in the art will appreciate that various modifications, combinations, sub-combinations, and substitutions can occur, depending on design requirements and other factors. Any modification, equivalent replacement, and improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.