门诊处方对医保大额赔付的影响分析及对策

Analysis of Influences of Outpatient Prescription to Health Care Big Compensation and It's Countermeasures

某市医保门诊大额赔付中,门诊处方是重要的理赔凭据,不合格的门诊处方产生的费用将被医保部门拒付。只有加强相关科室的沟通与协作、加强医保政策的学习与培训、完善处方提示功能、制定严格的奖惩制度和提高医生的业务水平,才能规范电子处方书写,减少医保的拒付,保障患者或医疗机构的合法权益。

Outpatient service prescription is an important claim credentials in large amount of health care compensation. Unqualified outpatient prescription costs will be refused to pay. Only to strengthen the communication and collaboration of relevant departments, strengthen the study and training of health policy, perfect prescription prompt functions, set strict rewards and punishment system and raise the level of the doctor＇s business, we can reduce refusal payment, protect the legitimate rights and interests of patients or medical institutions.