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目前,全民医保在我国顺利推行,各定点医疗单位都建立了较为规范的医保管理体系。在全民医保的大环境下,为了深化落实医疗卫生体制改革,不断推进新医改的进程,加大医院医保管理工作就变得尤为重要。医疗保险管理工作是医院管理工作的一部分,在医院医疗保险管理工作中,加强医保办环节的控制,能够保障医疗保险工作的顺利实施,合理控制参保患者的医疗费用,维护参保人员的医疗保障权益。本文结合工作实践,主要探讨了医院医疗保险管理中的管理机制、团队和人员结构、沟通协调能力、医院信息化系统等几个重要环节。
At present, universal health insurance is successfully implemented in our country, all fixed medical units have established a more standardized medical insurance management system. In the general medical insurance environment, in order to deepen the implementation of health care system reform, continue to promote the process of new medical reform, increase hospital health care management has become particularly important. Medical insurance management is a part of the management of the hospital. In the hospital medical insurance management, strengthening the control of the medical insurance office can ensure the smooth implementation of the medical insurance, reasonably control the medical expenses of the insured patients and maintain the medical care of the insured Protection of rights and interests. Based on the work practice, this article mainly discusses several important links such as the management mechanism, team and staff structure, communication and coordination ability, and hospital information system in the hospital medical insurance management.