Medical Insurance Settlement Audit Party Building Learning Q&A: Forms and Interactions

Medical Insurance Settlement Audit Party Building Learning Q&A: Forms and Interactions

What this category of data looks like

Data sources for this category include the national medical security information platform, hospital HIS and medical insurance interfaces, medical insurance catalog and coding library, and cross-regional medical settlement platform. Update frequency is daily. Daily processed documents include medical insurance settlement lists, expense details, medical record homepages, prescriptions, rejection lists, and settlement reconciliation statements. Fields include settlement identifier, insured person identifier, diagnosis and treatment project code, expense amount, rejection status, and others. Expense amount unit is Renminbi yuan. Coding-related fields follow the national unified medical insurance coding rules.

Multi-data source interface docking requires forms to support cross-source field mapping to avoid duplicate manual entry operations. Daily updated medical insurance catalog data requires the knowledge base associated with the form to trigger incremental indexing synchronously, ensuring retrieved content uses the latest rules. Field differences across multiple document types require forms to configure flexible field matching rules to adapt to settlement data from different sources. Single or batch settlement audit requirements require the interaction link to support single or batch submission, while also verifying required fields to reduce invalid requests, adapting to the associated retrieval scenario of policies and practical operations in party building learning Q&A.

How to set the configurations

Configuration ItemRecommended SettingRationale
formInput bound variableSelect medical insurance catalog library, settlement detail libraryAdapt to the associated retrieval requirement of policy interpretation and practical audit in party building learning Q&A, dynamically call category-specific medical insurance coding and settlement data
User selection trigger timingTrigger after form submissionMedical insurance settlement audit requires complete entry of expense details and insured information before starting retrieval, to avoid invalid pre-submission queries
Single search limitTop 10 entriesMedical insurance audit needs to match multi-dimensional details; too many results will increase the verification burden of audit personnel
Timeout threshold600 secondsRetrieval and matching of batch settlement data takes a long time, so sufficient processing time must be reserved
userSelect verification rulesRequired settlement order number, expense amountAvoid submitting invalid audit requests, ensure the effectiveness of subsequent retrieval
Batch import limit50 entries per batchAdapt to the audit requirement of single batch settlement, avoid system overload

Three common mistakes

  • Phenomenon: When applying variables in the knowledge base search node, the reference variable dropdown menu is empty. Cause: The bound variable of the medical insurance catalog library was not declared in the form configuration, causing the system to fail to recognize callable knowledge base resources.
  • Phenomenon: The connection entry for the code running tool is not displayed, and custom verification logic cannot be configured. Cause: The tool call permission switch for form interactions in FastGPT v4.17.0 was not enabled.
  • Phenomenon: After submitting the form question for the first time, matching medical insurance policy content is not recalled, and it can only be recalled on the second submission. Cause: The form did not synchronously trigger incremental update indexing for the knowledge base, causing the first retrieval to use outdated data.

How to confirm the configuration is complete

  • Access the form configuration page, check whether the variable list bound by formInput includes the medical insurance catalog library and settlement detail library options.
  • Submit a test form, check whether the knowledge base search node automatically calls the bound medical insurance catalog library and returns matching policy and settlement rule content.
  • Simulate batch import of settlement data, check whether the form intercepts submission requests with missing required fields.
  • Trigger a single retrieval, confirm that the number of returned results meets the configured single search limit.

The values given 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.