跨省异地就医联网结算对医保管理工作的挑战

Challenges of inter-provincial and inter-regional medical networking settlement to medical insurance management

跨省异地就医联网结算是医疗保险管理工作的重点内容之一。随着我国各地跨省异地就医联网结算工作的不断开展与推进,异地患者跨越参保地就医变得便捷而高效,网络信息数据实时交换简化了利用传统纸质材料审核方式的报销手续,使异地参保患者实现在就医地完成实时结算个人负担费用,减轻了患者的经济负担,缩短了异地患者医保报销等候时间。异地患者就医联网结算给医疗保险管理工作创造了机遇,同时也带了诸多挑战和新的压力。因此,在今后异地医保管理过程中,在保障医保基金安全的前提下,要不断整合各方力量,针对跨省异地就医联网结算工作中的重点环节,提高异地参保人员医保管理的工作质量。

The settlement of networked medical treatment in different places is one of the key contents of medical insurance management.With the continuous development and advancement of cross-provincial and remote medical network settlement work in China,it becomes convenient and efficient for patients from different places to seek medical treatment across the insured areas.The real-time exchange of network information data simplifies the reimbursement procedures by using traditional paper material auditing methods,enables patients from different places to complete the real-time settlement of personal burden costs,reduces the economic burden of patients,and shortens the waiting time for reimbursement of medical insurance for patients in different places was shortened.The networked settlement of patients in different places creates opportunities for medical insurance management,but also brings many challenges and new pressures.Therefore,in the future,in the process of medical insurance management in different places,under the premise of ensuring the safety of medical insurance funds,we should constantly integrate all forces to improve the quality of medical insurance management for the key links in the settlement of cross-provincial and remote medical network.