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我国已基本实现医疗保险全覆盖,这对老百姓带来了更多的社会保障,也给医院带来更多的挑战。做好医院医保管理工作,直接关系到参保人员的切身利益,也关系到医院的发展。笔者结合自身多年的工作经验,遵循把握精神、吃透政策、大力宣传、加强管理、狠抓落实,对如何做好医院医保管理工作有几点体会:完善管理组织,重视各环节的管理;密切监控病案,随时掌握医保动态;强化内部管理,规范医疗服务行为;医保财务协作,做好医保资金监督;加强宣传培训,确保医保政策执行。
China has basically realized the full coverage of medical insurance, which brings more social security to the common people and brings more challenges to the hospital. Doing a good job in the hospital medical insurance management is directly related to the immediate interests of the insured, but also to the development of the hospital. The author combines his many years of work experience, follow the grasp of the spirit, thoroughly understand the policy, vigorously promote, strengthen management, and implement it hard, how to do a good job in the hospital health care management experience: improve the management organization, emphasis on the management of all aspects; close monitoring Medical records should keep abreast of developments in health insurance. Internal management should be strengthened to standardize medical service activities. Medical and health care financial cooperation should be conducted to supervise medical insurance funds. Publicity and training should be stepped up to ensure the implementation of health insurance policies.