Under the guidance of the district medical insurance center, with the support of leaders at all levels and relevant departments, and in strict accordance with the policies, regulations and requirements of the state, city and district on medical insurance for urban workers, we will conscientiously fulfill the medical service agreement of designated medical institutions for basic medical insurance for urban workers in Neijiang City. Under the correct leadership of the president and the joint efforts of the medical staff in our hospital, the medical insurance work in 20 1 1 year was generally normal, and there were no cases such as excessive expenses, borrowing cards to see a doctor and out-of-range inspection. To a certain extent, it cooperated with the work of the district medical insurance center and maintained the safe operation of the fund. At present, our hospital has conducted a self-examination of xxx's annual medical insurance work, and made careful investigation and rectification according to the evaluation method. Now the self-examination situation is reported as follows:

First, improve the understanding of the importance of medical insurance.

In order to strengthen the leadership of medical insurance, our hospital set up a medical insurance work leading group composed of relevant staff, clearly defined the division of responsibilities to people, and ensured the implementation of medical insurance work objectives and tasks from the system. Organize all the staff to study the relevant documents carefully for many times, find out the gap, and actively rectify according to the actual work in our hospital. Focusing on the future and keeping pace with the times, * * will discuss the next medical insurance work and create a new situation in * * * medical insurance. Our hospital regards medical insurance as a major event in the hospital, actively cooperates with the medical insurance department, strictly controls non-compliant treatment items and drugs that should not be used, does not cross the line, and decisively takes fraudulent means to maliciously obtain medical insurance funds. Strengthen self-discipline and promote our hospital to strengthen self-supervision, self-governance and self-discipline. Further establish a good image of designated hospitals for medical insurance.

Second, strengthen the governance of medical insurance from the system.

In order to ensure the implementation of various systems, the hospital has improved various medical insurance governance systems, and combined with the actual work of our hospital, focused on the medical insurance objectives and tasks arranged by superiors. Formulated regulations and reward and punishment measures to further strengthen medical insurance governance, and stipulated the responsibilities of staff in various positions. The basic medical insurance system is sound, the relevant medical insurance management information is complete, and it is managed and archived according to the standard. Seriously and timely complete all kinds of documents, write medical records, nursing medical records and course records, and upload real medical insurance information to the medical insurance part in time.

Three, from the reality to do real medical insurance management.

According to the actual work of our hospital, the hospital strictly implements the regulations on the administration of basic medical insurance drugs. All drugs, diagnosis and treatment items and medical service facilities should be clearly marked and a detailed list of expenses should be provided. And repeatedly exaggerated to the medical staff, implemented the identity verification of medical staff, and tried to pretend to see a doctor.

Fourth, through self-examination, we found that our hospital's medical insurance work has made obvious achievements, but there is still a certain gap from the requirements of the medical insurance center, such as the basic work needs to be further consolidated. Analysis of the above shortcomings, mainly for the following reasons:

1. Individual medical staff do not attach importance to medical insurance, are unfamiliar with medical insurance in business, and do not know what to do, what not to do, and what to do in time.

2. In the process of seeing a doctor, there is a phenomenon that the process of medical insurance is not fully mastered.

3. The writing of medical records is not timely and comprehensive.

4. Failing to upload the medical insurance data such as disease diagnosis, drugs, diagnosis and treatment items of the insured employees correctly.

5. The focus of the next step.

In the future, our hospital should strictly implement the policies and regulations of medical insurance and consciously accept the monitoring and guidance of medical insurance. In view of the above shortcomings, the next step is mainly to take measures:

1, strengthen the study of medical staff's medical insurance documents and knowledge, improve their familiarity ideologically, and be completely paralyzed.