Ping An Medical Insurance Technology AI big data risk control system focuses on seven pain points of medical insurance risk control. In the aspect of algorithm design, it includes a variety of anomaly identification algorithms with the technical characteristics of Ping An Medical Insurance, and adopts a variety of advanced AI algorithm integration schemes, which can effectively mine potential fraudsters.
In the process of data management, automatic code matching and automatic table alignment technology are adopted to reduce the cost of manual code matching; On the knowledge base level, a unique 360 portrait system, scene database, standard index database, statistical rule database, policy rule database, empirical rule database and special governance database are constructed to support multi-dimensional anomaly identification.
In terms of architecture, innovative application mode * * * enjoys the architecture, realizes the balance between fast small-batch and large-batch data analysis, and achieves multiple goals such as stability, rapidity and resource saving.
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It is reported that the AI big data risk control system of Ping An Medical Insurance Technology has been applied in 12 provinces and cities nationwide, providing the provincial and municipal medical insurance bureaus with the overall solution of medical insurance risk control big data collection, storage, processing, analysis and service, and realizing data-driven operation and decision-making.
In July this year, the General Office of the State Council issued the Guiding Opinions on Promoting the Reform of the Supervision System of Medical Insurance Fund, which clearly required "to establish and improve the intelligent monitoring system of medical insurance and strengthen the application of big data. Accelerate the establishment of a centralized and unified intelligent monitoring system at the provincial level and even the whole country, and realize the transformation of fund supervision from manual withdrawal audit to all-round, full-process and full-link intelligent monitoring of big data. "
Ping An Medical Insurance Technology's "AI Big Data Risk Control System" can be described as stepping on the policy slogan. Through leading data technology, it can effectively help all localities to crack down on insurance fraud and comprehensively improve the level of fund supervision.