People who have had surgery because of bone problems should know that this kind of surgery is expensive even after medical reimbursement, and some orthopedic operations that require temporary implantation of instruments or permanent internal instruments are more expensive. The import and domestic prices of these high-value orthopedic medical consumables are relatively expensive in different departments of the hospital, some of which are several thousand yuan, and some can reach hundreds of thousands or even millions. Therefore, in just three years, Wuhan tongji hospital defrauded the medical insurance fund of more than 20 million yuan and illegally used more than 96,000 yuan.
However, this hospital relies on high-value orthopedic medical consumables to defraud the medical insurance fund by means of series charging, repeated charging and false charging. Tandem charging means that the hospital binds consumables with other consumables when filling in, which is difficult to find. Repeated charging means that a consumable is charged several times in the process of charging, but it is actually used only once. False charges refer to the hospital forging the unit price of consumables and doing some operations on the reported quantity.
In addition, this hospital still uses unused consumables in the financial system, but these high-value orthopedic consumables are not purchased or consumed at all, and even in the hospital warehouse, they are filled into the consumed financial reimbursement, which makes it difficult for the medical insurance fund to find these small moves during the investigation and will not doubt this big hospital, so Wuhan tongji hospital has completed the process of defrauding the high-value medical insurance fund.