医疗保险异地就医即时结算存在的问题及对策

Problems in the Long-distance Basic Health Insurance Settlement and Countermeasures

基本医疗保险异地就医联网结算是加快推进基本医疗保障制度建设的一项重要举措,也是解决参保患者看病难、看病贵的重要途径。安徽省从2014年已经开始试点的基础上分阶段推进异地医保就医的结算工作,蚌埠市某省级综合医院作为异地医保联网结算试点医院,从2016年起开始全面实施异地医保联网结算工作。笔者以该院为例,阐述了异地医保病人在该院即时结算中存在的主要问题,并针对问题进行分析研究,提出了解决异地医保就医结算难问题的对策。

Basic health insurance online settlement is an important measure to accelerate the construction of basic medical security systems and is an important way to solve the problem of difficulties and high expense in medical treatment. Anhui province implemented health insurance online settlement by stages on the basis of being the pilot from 2014. In Anhui, one provincial general hospital has comprehensively launched the long - distance health online settlement fi＇om 2016. Based on this hospital, we expound the main problems of online health settlement we encountered, then analyze those problems, and finally put forward the solutions for solvin~ the t^roblems of lon~ - distance health insurance online settlement.