随着我国社会医疗保障体系的不断发展和完善,天津市新型农村合作医疗保险制度、公费医疗制度与医保并轨,医保工作也从最初的面向参保人员的政策咨询、解释、宣传及解决参保人员与医院之间的纠纷、办理相关医保手续,进一步发展到对患者医疗费用的监测与审核。文章通过对日常医保审核工作中常见问提的分析,提出相应的防范措施,最大限度地减少医保拒付问题的发生。 With the continuous development and improvement of social medical security system in our country, the new rural cooperative medical insurance system in Tianjin, merged medical insurance system with medical insurance, and the medical insurance also consult, explain, publicize and solve the policy from the initial policy for insured persons Disputes between personnel and hospitals, for medical insurance procedures, and further development of the patient’s medical costs monitoring and review. Through the analysis of the frequently asked questions in daily medical insurance audit work, the article puts forward corresponding preventive measures to minimize the occurrence of medical insurance protest.