Ping An Medical Insurance Technology's big data AI risk control system uses AI technology to identify data anomalies, and identifies behaviors such as insurance fraud, cheating and violation in data anomalies. Among them, AI-supported anomaly identification, AI-supported data governance, automation of code work and table alignment are the unique competitiveness of the risk control system.
Ping An Medical Insurance Technology AI Big Data Risk Control System focuses on the seven pain points of medical insurance risk control. In the aspect of algorithm design, it includes a variety of anomaly identification algorithms with Ping An medical insurance technology characteristics, and uses 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, which reduces the cost of manual code matching; On the knowledge base level, a unique 36 portrait system, scene database, standard index database, statistical rule database, policy rule database, empirical rule database and special governance database are constructed, which supports multi-dimensional anomaly identification.
In terms of architecture, the innovative application model * * * enjoys the architecture, so as to achieve the balance between fast small-batch and large-batch data analysis, and achieve multiple goals such as stability, rapidity and resource saving.
Extended information:
It is reported that Ping An Medical Insurance Technology AI Big Data Risk Control System has been applied in 12 provinces and cities across the country, providing the provincial and municipal medical insurance bureaus with the overall solution of big data collection, storage, processing, analysis and service for medical insurance risk control, 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 medical insurance intelligent monitoring system 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 drawing audit to all-round, whole-process and all-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, which can effectively help all localities to crack down on fraudulent insurance and comprehensively improve the fund supervision level through leading data technology.