insurance-claim-document-processing

What problem does it solve?

This Skill helps insurance claims teams convert uploaded claim documents (medical invoices, medical records, appraisal reports, and expense lists) into structured, audit-friendly outputs by performing OCR-based extraction, standardized categorization, completeness checks, cross-document consistency validation, and medical timeline summarization—while enforcing strict grounding to avoid guessing missing data.

Core Features & Use Cases

• 全链路理赔材料解析：对理赔图片/PDF进行一次性多模态分析，输出统一结构化结果（目录、摘要、审计信息）。
• 材料分类与合规校验：自动归入标准类别（医疗发票、病历资料、鉴定报告、鉴定费用、费用清单、其他），并进行完整性/一致性/交叉验证风险标注。
• 病程时间线梳理：从医疗类文档提取诊疗关键节点，按时间线输出病程摘要与关键信息用于审核跟进。
• 合规与审计能力：每项结论必须标注数据来源与置信度，异常触发预警并要求人工确认，生成审计日志（JSONL 追加）。

Quick Start

Run the skill on your local materials folder by providing the insurance claim input directory and your DashScope API key, then choose the execution scope (e.g., 全部 or 分类/完整性/一致性/交叉验证/病程时间线) to obtain standardized audit reports.