为适应社会主义市场经济发展的客观需要,各地人保公司相继开办了各类医疗保险业务,拓宽了人身险业务的服务领域。但由于医疗保险涉及面广、专业性强、技术管理难度大,加之现行的医疗保险给付管理实行的是一种事后的、被动的监督、审核办法,以致费用成本增大,给付率连年居高不下,严重影响了医疗保险的社会和经济效益。笔者认为现行医疗保险给付管理办法存在以下几方面问题: 一、依据医疗部门票据给付保险金漏洞百出。 随着经济体制改革的进一步深化,医疗部门也由社会福利型转变为企业经营型。医院普遍实行了院 In order to meet the objective needs of the development of a socialist market economy, PICC companies throughout the world have successively opened various medical insurance businesses and broadened the service areas for personal danger insurance businesses. However, due to a wide range of medical insurance coverage, professionalism, technical management is very difficult, combined with the current health insurance payment management is implemented by a passive, passive supervision and audit methods, resulting in cost costs increase, the rate of payment year after year high No less than, seriously affected the social and economic benefits of medical insurance. The author believes that the existing medical insurance payment management methods exist in the following aspects: First, according to the medical department bills payment insurance funds full of loopholes. With the further deepening of the reform of the economic system, the medical sector has also changed from a social welfare type to a business type. Hospital generally implemented hospital