衢州市医疗费用报销实现“3+N”一站式自动结算的实践路径

Practice Path Of Realizing"3+N"One-stop Automatic Settlement Of Medical Expenses Reimbursement In Quzhou

为解决多部门医疗费用报销环节复杂,事后结算烦、延时报销难等问题,衢州市医保局突破部门职责分割限制,借助信息系统支撑,颗粒化业务环节,创建部门资金池,建立起多部门医疗费用报销(补助)联办机制。通过医疗费用"一站式"自动结算实现了老百姓报销零跑腿、零垫付、零等待,大幅提升了医保治理能力。

In order to solve the problems such as complicated reimbursement links of multi departments,troublesome settlement after the event,and difficulty in delayed reimbursement,Quzhou Healthcare Insurance Bureau broke through the division of responsibilities of departments,with the support of information system,granulated business links,created Department fund pool,and established a joint mechanism of multi department medical expense reimbursement(subsidy).Through the"one-stop"automatic settlement of medical expenses,people’s reimbursement of zero errand,zero advance and zero waiting has been realized,which greatly improves the medical insurance governance ability.