摘要
随着医疗保险制度的进一步深化,城镇居民和企事业单位的参保率不断提升,定点医疗单位的数量也不断增加,基本实现了城镇的全覆盖,这就使得医疗保险工作的管理难度不断加大。医疗保险稽核工作是医院管理工作的重要组成部分,要想实现医院管理水平的提升,就要更加重视医疗保险稽核工作,充分发挥稽核工作的监督审查作用,保证医院的医疗保险工作平稳运行,真正使医疗保险达到普惠、公平、公开的目标。文章主要针对医疗保险稽核工作进行分析,重点研究稽核工作的重要性以及更好地开展稽核工作的措施。通过实施严格的稽核协作机制,促使医疗定点机构按照规范开展医疗保险的稽核工作,不仅是提升稽核工作水平的重要举措,更是推动医疗改革的有效途径。
With the further deepening of the medical insurance system,the participation rate of urban residents,enterprises and institutions has been increasing,and the number of designated medical units has been increasing,basically realizing the full coverage of cities and towns,which makes the management of medical insurance more difficult.Medical insurance audit is an important part of hospital management.To improve the level of hospital management,it is necessary to pay more attention to medical insurance audit,give full play to the role of supervision and examination of audit,ensure the smooth operation of hospital medical insurance,and truly make medical insurance universal,fair and equitable.This paper mainly analyzes the audit of medical insurance,focusing on the importance of audit work and measures to better carry out the audit work.It is not only an important measure to improve the level of audit work,but also an effective way to promote the medical reform to urge the designated medical institutions to carry out the audit work of medical insurance in accordance with the norms by implementing a strict audit cooperation mechanism.
作者
聂歆赢
NIE Xinying(Medical Insurance Office,Xinjiang Shihezi Economic andTechnological Development Zone Hospital,Shihezi Xinjiang 832000,China)
出处
《中国卫生标准管理》
2019年第1期23-25,共3页
China Health Standard Management
关键词
医疗保险
稽核工作
重要性
措施
策略
协作机制
medical insurance
audit work
importance
measures
strategy
cooperation mechanism
