What the data for this category looks like
Data for this category comes from the national medical insurance information platform, hospital HIS and medical insurance interfaces, medical insurance catalog and coding library, and cross-regional medical treatment settlement platform. It is updated daily. Daily processed documents include medical insurance settlement lists, expense details, medical record homepages, prescriptions, rejection lists, and settlement reconciliation statements. Data fields include settlement number, insured person identity identifier, diagnosis and treatment project and drug consumables codes, expense amount, rejection reason, reconciliation status, and more. Units include yuan, number of visits, coding standard values, and more.
What constraints these characteristics impose on model access and configuration
The daily updated data scale and update rhythm require the model access link to support high-frequency batch calls. The single-round processing token limit must be set to avoid timeouts. Multi-source heterogeneous data formats require configuration items to be compatible with the field structures of different documents. This prevents field parsing failures caused by format mismatches. Medical insurance-related documents include professional coding and compliance requirements. The model's prompt words must be adapted to the standards of the medical insurance catalog library. Sufficient context space must also be reserved to accommodate settlement details and reconciliation data, to prevent key information from being truncated.
How to set configurations
Reference only; verify against the target FastGPT release and deployment documentation.
| Configuration Item | Recommended Value Range | Rationale |
|---|---|---|
maxTokens | 8000–12000 token | Supports complete parsing of long texts such as medical insurance settlement lists and rejection lists, avoiding truncation of key audit information |
maxContext | 6000–10000 characters | Accommodates context association of batch settlement data, supports synchronous processing of multiple details and reconciliation data |
quoteMaxToken | 2000–3000 token | Limits the length of a single piece of referenced data, preventing abnormal model output caused by context overflow |
temperature | 0.1–0.3 | Reduces randomness, ensuring that coding matching and expense audit results comply with fixed rules of the medical insurance catalog |
toolChoice | auto | Automatically selects appropriate tools to handle subtasks such as coding matching and reconciliation verification, adapting to multi-step audit processes |
AIPROXY_API_TOKEN | Assigned based on role permissions | Adapts to the security management requirements of medical insurance data, restricting interface access permissions for different handling institutions |
Three common errors
- An "invalid API Key" error is returned when calling the workflow. Cause: A globally universal API Key is used directly to call the application conversation interface, and the exclusive permission configuration of the corresponding workflow is not used.
- Settlement audit result fields are missing after workflow execution. Cause: The
maxContextparameter is not set correctly. The context of batch settlement details is truncated, making it impossible to complete coding and expense matching verification. - Question classification results do not meet expectations for the medical insurance audit scenario. Cause: The
temperatureparameter is not adjusted for the professional scenario, or the prompt words are not adapted to the professional requirements of the medical insurance catalog and settlement rules.
How to confirm the configuration is complete
- Call the test interface, check the returned API call logs, and confirm that the configurations of
AIPROXY_API_TOKENandAIPROXY_API_ENDPOINTmatch the deployment environment. - Submit a single medical insurance settlement list and batch detail data, and check whether the ledger fields output by the model cover core audit content.
- Trigger workflow execution, monitor the running duration, and confirm that the processing duration meets business requirements without obvious timeouts.
- Adjust the
temperatureparameter and compare output results, ensuring that the consistency of audit logic complies with the fixed requirements of medical insurance rules.
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.