The self-inspection report and rectification measures of medical insurance in a certain hospital

After watching CCTV's Focus Interview, which exposed the incident that fictitious patients were admitted to Aji Hospital in Acheng District, Harbin City, Heilongjiang Province,

As medical workers, we deeply realized the necessity and importance of doing a good job in medical insurance, and enhanced our sense of responsibility and mission to do our job well.

The medical insurance department of our hospital has carried out a special medical insurance inspection for urban workers and residents in the whole hospital, seriously reflected on their own situation in terms of ideology, work style and discipline, and conducted a profound discussion and analysis. Now we report the inspection results and rectification measures as follows:

Under the leadership of the higher authorities, our hospital has been strict since the medical insurance work was carried out

. Earnestly implement the medical insurance policy

:

1.

After receiving the notice, our hospital immediately set up a special inspection team with the chief of the medical insurance department as the main point

,

compared with the relevant provisions of medical insurance,

found out the shortcomings,

actively rectified,

our hospital has always attached great importance to medical insurance work, with a special management team and a relatively high level.

2.

Make medical insurance consumption transparent. There is a medical insurance bulletin board in the hospital, and the items of drug diagnosis and treatment are clearly marked, providing them with detailed expenses, and resolutely putting an end to illegal phenomena such as pretending to live in the hospital, decomposing hospitalization and hanging up beds. Doctors use drugs according to the list

,

self-funded drugs and items can ask for patients' consent,

strictly grasp the admission criteria,

strive to settle accounts according to the medical insurance quota, control self-funded expenses, and settle expenses for patients in time

. The violations found in the monthly regular spot check of medical records and irregular on-site inspection

in the medical insurance center can be corrected in time and immediately.

3

, standardize the writing of medical documents of medical staff in the hospital. The medical insurance department

organizes young doctors to set up special inspection teams from time to time to check and study the medical records of medical insurance patients in the whole hospital, and makes corresponding punishments for doctors who can't improve their medical records in time, and

conducts professional studies under the supervision of leaders in charge, and also gives corresponding affirmation and encouragement to doctors who have better medical records.

4

The proportion of long-term drug expenses in the total expenses in our hospital exceeds the standard. The special reason is that our hospital mainly treats cardiovascular and cerebrovascular diseases, and there are more patients with cardiovascular and cerebrovascular diseases. These patients with chronic diseases have a long treatment period and expensive drugs, and the drug expenses remain high, but the medical insurance leading group of our hospital decided to strictly supervise and

try its best to reduce them.

In order to ensure that the insured workers enjoy better basic medical services,

our hospital will

further improve the quality management of designated medical institutions, improve service awareness and

service level, strictly control policies, start with details, and constantly improve various systems,

and strive to push our medical insurance work to a new height!