“军卫一号”医保结算中存在的问题及解决办法

Problems and Solutions in Medical Insurance Settlement of No.1 Military Medical Project

简要总结了医保结算中存在的药品和诊疗项目没有对照关系、医院和医保两方的账不平、医保个人信息变更和医保特殊政策等4个方面的问题,并提出了相应的解决办法。

This paper summarizes four problems in medical insurance settlement. Firstly, there is not a comparison relationship between drugs and diagnosis-treatment projects. Secondly, the bills of hospitals and health insurance are not agreed for each other. Thirdly, personal information of medical insurance is always changing.The last one is the particular policy of medical insurance. In addition, this paper also provides the corresponding solutions.