What the Data for This Use Case Looks Like
The service subjects for this use case include medical insurance handling institutions, designated hospital medical insurance offices, designated pharmacies, and medical insurance information platform operators. Data sources include the national medical insurance information platform, hospital HIS and medical insurance interfaces, medical insurance catalogs and coding libraries, and cross-regional medical settlement platforms. The update frequency is daily. Daily processed documents include medical insurance settlement lists, expense details, medical record homepages, prescriptions, rejection payment lists, and settlement reconciliation statements. Data fields include settlement order numbers, insured person identity identifiers, diagnosis and treatment project codes, drug and consumable expenses, rejection reasons, reconciliation flags, and more. All data characteristics strictly follow business facts from industry research. No additional statistics or percentage content are added.
Constraints for HTTP Interfaces and External Systems
Daily updated data sources require interfaces to support daily batch data pulling. This avoids external interface pressure caused by frequent calls. Multiple document and field types require interfaces to support specified field filtering. This accurately retrieves core audit data such as settlement order numbers, expense details, and rejection reasons, reducing invalid data transmission. Multi-source data interaction requires compatibility with authentication rules of different external systems. It also requires consistent data transmission to avoid audit errors caused by field format deviations. Data processing rigor requires interfaces to include timeout retry and error log recording capabilities. This addresses network fluctuations or temporary external system exceptions.
Configuration Settings
| Configuration Item | Recommended Setting | Rationale |
|---|---|---|
| Authentication Method | Configure the Authorization header as Bearer Token format, with the secret key provided by the medical insurance platform | Complies with general authentication specifications for medical insurance external interfaces, ensuring interface access security |
| Request Parameter Configuration | Set variables as an object containing settlement date range and data type | Accurately pull daily updated medical insurance settlement data, avoiding redundant requests |
| Response Data Filtering | Configure responseData to return only core audit fields | Reduce data transmission volume, improve interface processing efficiency, and meet the field requirements for ledger summary |
| Timeout Threshold | 600 seconds | Adapts to the time consumption requirements of batch data pulling, avoiding request interruptions caused by large data volumes |
| Retry Mechanism | Set 2 retries with a 3-5 second interval based on actual measurements | Respond to network fluctuations or temporary external system failures, ensuring data pulling success rate |
| Data Format Validation | Enable automatic field format validation | Ensure returned data complies with medical insurance coding and field standards, adapting to the interface call specifications of FastGPT v4.17.0 |
Three Common Configuration Mistakes
- Phenomenon: The returned ledger data includes one duplicate historical settlement record after calling the interface. Cause: No deduplication parameter was configured in
variables, resulting in repeated pulling of the previous day's settlement data. - Phenomenon: The interface call returns status code 401, and medical insurance data cannot be pulled normally. Cause: The secret key in the
Authorizationheader was not configured correctly, or the secret key has expired and become invalid. - Phenomenon: When streaming return is enabled, the final report generation result cannot be received completely. Cause: The correct result splicing logic was not configured, and only partial streaming return data packets were received.
How to Confirm Proper Configuration
- Call the test interface and check whether the fields returned in
responseDatainclude core audit data such as settlement order numbers and expense details. - Check whether the format of the
Authorizationheader is Bearer Token plus a valid secret key, and verify authentication validity using an interface debugging tool. - Initiate a batch data request and verify that the number of returned data entries matches the expected number of that day's medical insurance settlement data.
- After enabling streaming return mode, verify that all streaming returned report generation content can be received completely.
The values provided are common starting points and should be measured against the reader's own samples.
Question material comes from public community discussions. Configuration values are common starting points and should be measured against your own samples. Verified on 2026-09-28.