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Method and device for identifying social security fraud

An identification method and an identification device technology, which are applied in the field of identification methods and devices for social insurance fraud, can solve the problems of low accuracy and achieve the effect of high accuracy

Active Publication Date: 2018-07-31
PING AN TECH (SHENZHEN) CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0004] The main purpose of the present invention is to provide a method and device for identifying social security fraud, aiming to solve the existing technical problem of low accuracy in the identification of social security fraud

Method used

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  • Method and device for identifying social security fraud
  • Method and device for identifying social security fraud
  • Method and device for identifying social security fraud

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Embodiment Construction

[0051] It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

[0052] It should be understood that the existing single rule triggering mechanism refers to the rule triggering mechanism sorted out by the FWA (Favorite Website Awards, multimedia website collection platform) system based on business experience, and fraud identification is only done from single-dimensional data modeling, such as the FWA system Restrictions on the amount of treatment, the amount of medication, and the corresponding relationship between medicines, single-dimensional data modeling to identify suspected fraudulent treatment receipts, etc. The above fraud identification is difficult to identify the fraud of cumulative crimes and group crimes. For example, judging from the single-dimensional data, it is normal to use medicines. However, these methods and models are difficult to identify some complex frauds,...

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Abstract

The invention discloses a method for identifying fraudulent behaviors of social security. The method includes: establishing a relationship network between doctors and patients and medical clinics based on social security consultation data, wherein the relationship network includes various nodes, and each node belongs to a different relationship. ; analyze the group medical-seeking behavior of each node in the relationship network to extract the multi-dimensional group medical-seeking characteristics corresponding to each node; input the extracted multi-dimensional group medical-seeking characteristics into a preset classification model, so as to The above classification model identifies the fraud rate of each node. The invention also discloses a device for identifying social security fraud. The invention identifies social security fraud from multiple dimensions and angles, and has higher accuracy in identifying social security fraud than the traditional single-rule identification.

Description

technical field [0001] The invention relates to the technical field of computer applications, in particular to a method and device for identifying social security fraud. Background technique [0002] With the improvement of people's living standards, people's awareness of their own security is gradually increasing, and more and more people will purchase social insurance to reduce the economic burden caused by accidents. Correspondingly, there will be some social security fraudulent behaviors, such as falsifying medical records, changing medical expenses, and so on. [0003] At present, when identifying social security fraud, a single rule trigger mechanism is mostly used for identification. Due to the single rule trigger mechanism, the identification chain of evidence for social security fraud is single, which easily leads to a high rate of misjudgment. Contents of the invention [0004] The main purpose of the present invention is to provide a method and device for iden...

Claims

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Application Information

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Patent Type & Authority Patents(China)
IPC IPC(8): G06Q40/08G06F17/30
CPCG06F16/283G06Q30/0185G06Q50/26G16H50/70G06F18/22G06F18/217G06F18/24G16H40/20G16H15/00G16H10/60G06Q50/265G06F18/213
Inventor 阮晓雯徐亮肖京
Owner PING AN TECH (SHENZHEN) CO LTD
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