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医疗监督是保证基金平衡,查处违规行为,降低群众负担的重要环节,如何做好这项工作是各级医保经办机构面临的共同课题。近年来,南充市医保中心在审核报销参保人员医药费用时,发现并查处了二十多起违规行为,避免基金损失10多万元,实践中他们体会到,要做好这项工作,除了熟悉医疗环节,掌握医保政策外,最关键的是要有高度的责任心,善于从不起眼的细节中发现蛛丝马迹,让做假者无空子可钻。
Medical supervision is to ensure fund balance, investigate and deal with non-compliance, reduce the burden on the masses an important part of how to do this work is at all levels of health insurance agencies face the common issue. In recent years, Nanchong Medical Insurance Center in reviewing the reimbursement of medical expenses of officers, found and investigated more than 20 violations, to avoid the loss of more than 10 million fund, in practice they realized that to do this work, in addition to Familiar with the medical sector, health insurance policy, the key is to have a high degree of sense of responsibility, good at humble details found in the clues, so that fake impractical to drill.