What Data Looks Like for This Category
Data sources primarily include medical insurance settlement details, outpatient and inpatient electronic medical records, and historical insurance notification records. Updates occur in real time when a claim application is triggered, or via daily batch pulls for full updates. Document structures mostly combine structured fields and unstructured text. Structured fields include treatment date, medical institution name, diagnosis code, and expense details. Unstructured content includes medical chief complaints and medical orders. Required fields include ICD-10 diagnosis codes, treatment serial numbers, and medical insurance overall planning payment amounts. Units must follow standard medical insurance settlement formats. Some fields must align with unified national medical insurance bureau coding specifications.
Constraints Imposed on HTTP Interfaces and External Systems
Mixed structured and unstructured data structures require HTTP interfaces to support both form field submission and file upload. Specialized coding fields require the interface’s input parameters to include standardized coding verification logic. This prevents non-compliant codes from entering the workflow. Real-time synchronization requirements mean interface timeout values must accommodate delays in batch pull scenarios. The interface must also support resumable uploads. Compliance requirements for medical insurance-related fields mean external systems must connect to national medical insurance interfaces for coding verification. This adds interface dependency links. Multi-source data access requires interfaces to support format conversion and adaptation for different data sources. Field mapping configuration options must be reserved.
How to Set Configurations
| Configuration Item | Recommended Value | Rationale |
|---|---|---|
PARSE_FILE_TIMEOUT_SECONDS | 600 seconds | Medical records and medical insurance settlement files associated with pre-existing condition determination are typically lengthy. Their parsing time exceeds that of general documents. This setting accommodates long parsing needs. |
UPLOAD_FILE_MAX_SIZE | 1000 MB | Files such as medical insurance settlement details and inpatient medical records may exceed the size limit for general documents. This setting relaxes upload restrictions. |
Knowledge base recall count | Top 8–12 entries | Pre-existing condition determination requires covering multiple sources of historical treatment records. A sufficient number of associated documents must be recalled to cover determination basis. |
Similarity threshold | 0.78–0.82 | Pre-existing condition diagnosis requires strict matching of codes and treatment scenarios. A higher threshold reduces false recall rates. |
Knowledge Base API Context Optimization | Enabled | A large number of referential questions exist in claims scenarios. Historical conversation records can optimize current question phrasing and resolve coreference issues. |
HTTP_REQUEST_RETRY_TIMES | 3 times | Temporary network fluctuations may occur when connecting to external medical insurance interfaces. A reasonable number of retries ensures request stability. |
The parameter values provided on this page are common recommended starting points for configuration. Actual values are affected by material format, data volume and business rules. Specific issues require specific analysis. It is recommended to test on your own samples before finalizing settings.
Three Common Mistakes
- Symptom: After uploading HTML interface documents generated by Javadoc, no matching content appears in knowledge base searches, and parsing results are empty. Cause: The default document parser does not adapt to the tag structure of HTML structured documents, and fails to extract valid text and field information.
- Symptom: The front-end interface can complete file upload, but when calling the chat API, the uploaded file parameters cannot be carried. The interface returns a parameter missing error. Cause: The request format of the chat API is not set to multipart/form-data, and file transfer still uses the application/json format.
- Symptom: When calling the knowledge base API, questions containing referential expressions (such as "What is its diagnosis code?") cannot correctly associate historical conversation content, and the returned results do not meet expectations. Cause: Historical conversation context parameters are not passed in the knowledge base API request, and context optimization configuration is not enabled.
How to Confirm Configuration is Complete
- Uploading a standard medical insurance settlement detail file enables review of parsed text and field extraction results. The parsing duration is verified to not exceed the configured timeout threshold.
- Calling the chat API with a test file parameter allows checking if the interface return contains valid content from the parsed file. The request format and upload limit configuration are confirmed to meet requirements.
- Passing a test question containing referential expressions and historical conversation context enables checking if knowledge base search results correctly associate historical content. The context optimization configuration is verified to be active.
- Triggering a model call request allows checking if the return result is normal. The model configuration is confirmed to match that of the external model management platform.
Question material comes from public community discussions. Configuration values are common starting points and should be measured against your own samples. Verified on 2026-09-14.