What This Category of Data Looks Like
This category of data draws from the national medical insurance information platform, hospital HIS systems, medical insurance docking interfaces, medical insurance catalog coding libraries, and cross-regional medical settlement platforms. Data updates occur daily. Daily processed documents include medical insurance settlement lists, expense details, medical record homepages, prescriptions, rejection payment lists, and settlement reconciliation statements. Field combinations vary across different documents. Core fields cover settlement order numbers, insured person identity identifiers, diagnosis and treatment project codes, drug and consumable codes, expense amounts, and rejection reasons. Field matching and verification must be completed based on medical insurance coding rules.
Constraints on Tool Calling and Plugins From These Data Characteristics
Multi-data source access requirements mean tool calling must support docking with different types of external interfaces. This integrates medical insurance data from multiple platforms. Daily update frequency requires tool calling to support real-time synchronization. This ensures processed data stays up to date. Handling multiple document types requires plugins to adapt to different document formats. This accurately parses medical insurance document content from various sources. Accurate code matching requires tool calling to invoke the medical insurance catalog library. This completes code verification for diagnosis and treatment projects, drugs, and consumables, avoiding audit deviations from coding errors. Batch processing scenarios require tool calling to support batch requests. It also requires controlling concurrency to avoid exceeding external interface call limits.
Configuration Settings
| Configuration Item | Recommended Setting | Rationale |
|---|---|---|
toolChoice | auto | Adapt to multi-source medical insurance document parsing and code matching needs, automatically select appropriate tool plugins |
functionCall | Enabled | Support calling custom plugins such as medical insurance catalog query and data verification, to complete code matching and expense audit |
| Single batch processing limit | 100 entries | Match batch audit scenarios for daily updated settlement data, avoid exceeding interface concurrency limits |
| Timeout threshold | 600 seconds | Adapt to latency of cross-platform interface calls, ensure complex verification processes have sufficient execution time |
| Result matching threshold | Calibrated based on actual testing | Avoid irrelevant medical insurance code matching results from interfering with audit logic, adjust based on local business rules |
| Document output template | Preset medical insurance settlement document format | Adapt to subsequent document drafting needs, ensure output content complies with medical insurance handling specification requirements |
Three Common Mistakes
- When multiple API requests are sent in a short period, subsequent requests queue and cannot directly interrupt the current generation process. This occurs because concurrency request limits are not configured, or related request interruption settings are not enabled.
- After configuring a document parsing plugin with a custom URL, no return data is received and the interface status code is normal. This occurs because the target URL is not added to the allowed access list of the document parsing plugin, or the encoding format of the target document does not match the preset rules.
- After the workflow runs, the model's output audit results cannot automatically generate documents. This occurs because a document export plugin is not added to the workflow, or the mapping relationship between output fields and document templates is not configured.
How to Confirm the Configuration Is Complete
- Log in to the FastGPT v4.17.0 management backend, view tool calling logs, and confirm that the medical insurance catalog matching plugin triggers when an audit request is initiated.
- Initiate a single settlement order audit request, check whether returned results include matched diagnosis and treatment project codes and expense verification results.
- Configure a document parsing plugin with a custom URL, import a test medical insurance settlement list URL, and confirm that expense details and insured person information fields are parsed.
- Run a workflow that includes a document export step, confirm that the generated document includes core audit result fields, and the format complies with preset medical insurance settlement document specifications.
The values provided here are common starting points, and should be evaluated 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.