医疗保险纠纷分析与防范对策

Medical insurance dispute and its countermeasures

本文分析了28例医保纠纷,总结其产生原因有以下5个方面:医保管理流程执行不严(46.43%)、对医保政策理解有误(28.57%)、执行医保政策不到位(10.71%)、违反物价管理规定(7.14%)、其他因素(7.14%),并针对纠纷产生的原因提出防范对策。

Twenty-eight medical insurance dispute cases were analyzed in this paper.The reasons why such disputes occurred were summarized as follows：imperfect medical insurance management（46.43%）,misunderstanding of medical insurance policy（28.57%）,ineffective implementation of medical insurance policy（10.71%）,violation of price regulation（7.14%）,and other factors（7.14%）.Certain measures were suggested for the solution of such disputes based on their occurrence reasons.