融合视觉语言模型与传统算法,实现医疗理赔文档高效精准解析
A Hybrid Architecture for Multi-Stage Claim Document Understanding: Combining Vision-Language Models and Machine Learning for Real-Time Processing
- 分阶段架构结合PaddleOCR、逻辑回归与Qwen-VL模型处理多类型文档
- 文档分类准确率超95%,字段提取率达87%,单文档平均耗时不足2秒
- 已部署于移动应用,支持越、新两国每周数万份理赔单实时处理
理赔文档是医疗与保险运营的基础,用于报销、审计和合规。然而这些文档通常非数字化,多为扫描件或在非受控条件下拍摄的照片,内容异质性强,涵盖打印发票与手写病历,语言多样。以全尔顿健康为例,其每年处理数千万份理赔单,覆盖新加坡、菲律宾、印尼、马来西亚、中国大陆、香港、越南、巴布亚新几内亚和柬埔寨九个市场。这种多样性,加之图像质量不一和版式差异,极大阻碍了自动化解析与结构化信息提取。本文提出一种多阶段流水线系统,整合多语言光学字符识别引擎PaddleOCR、传统逻辑回归分类器与轻量级视觉-语言模型Qwen 2.5-VL-7B,实现大规模理赔数据的高效精准字段提取。系统文档类型分类准确率超过95%,字段级提取准确率约87%,单文档平均处理延迟低于2秒。相较人工处理每份需约10分钟,效率提升300倍。结果表明,结合传统机器学习与现代视觉-语言模型,可实现生产级精度与速度。该方案已成功部署于移动端应用,目前正持续处理越南与新加坡每周数万份理赔单。
原文摘要 · Abstract (English)
Claims documents are fundamental to healthcare and insurance operations, serving as the basis for reimbursement, auditing, and compliance. However, these documents are typically not born digital; they often exist as scanned PDFs or photographs captured under uncontrolled conditions. Consequently, they exhibit significant content heterogeneity, ranging from typed invoices to handwritten medical reports, as well as linguistic diversity. This challenge is exemplified by operations at Fullerton Health, which handles tens of millions of claims annually across nine markets, including Singapore, the Philippines, Indonesia, Malaysia, Mainland China, Hong Kong, Vietnam, Papua New Guinea, and Cambodia. Such variability, coupled with inconsistent image quality and diverse layouts, poses a significant obstacle to automated parsing and structured information extraction. This paper presents a robust multi-stage pipeline that integrates the multilingual optical character recognition (OCR) engine PaddleOCR, a traditional Logistic Regression classifier, and a compact Vision-Language Model (VLM), Qwen 2.5-VL-7B, to achieve efficient and accurate field extraction from large-scale claims data. The proposed system achieves a document-type classification accuracy of over 95 percent and a field-level extraction accuracy of approximately 87 percent, while maintaining an average processing latency of under 2 seconds per document. Compared to manual processing, which typically requires around 10 minutes per claim, our system delivers a 300x improvement in efficiency. These results demonstrate that combining traditional machine learning models with modern VLMs enables production-grade accuracy and speed for real-world automation. The solution has been successfully deployed in our mobile application and is currently processing tens of thousands of claims weekly from Vietnam and Singapore.
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