The first is to optimize the medical insurance service process.
The medical insurance department of the hospital will strive to optimize the medical insurance service process, simplify the reimbursement procedures for patients and improve the reimbursement efficiency. By improving the medical insurance information system, the real-time updating and sharing of medical insurance data can be realized, and the waiting time of patients and information input errors can be reduced. At the same time, strengthen the publicity and training of medical insurance policy, improve the medical staff's medical insurance knowledge level, and ensure the smooth implementation of medical insurance policy in hospitals.
Second, improve the quality of medical services.
The medical insurance department of the hospital will strengthen the supervision of medical quality to ensure the safety, effectiveness and rationality of medical services. Through the establishment and improvement of medical quality management system, strengthen the monitoring and evaluation of medical process, and find and correct medical quality problems in time. At the same time, strengthen the training and assessment of medical personnel to improve their professional quality and medical service level.
Third, reduce the burden of patients' medical expenses.
The medical insurance department of the hospital will actively implement the medical insurance policy, reasonably control medical expenses and reduce the burden on patients. Through consultation with the medical insurance department, we will strive for more financial support for medical insurance and reduce the proportion of patients at their own expense. At the same time, strengthen the audit and supervision of medical expenses to prevent unreasonable charges and excessive medical treatment.
Fourth, strengthen communication and cooperation with the medical insurance department.
The hospital medical insurance department will strengthen communication and cooperation with the medical insurance department, keep abreast of the changes and requirements of medical insurance policies, and ensure the smooth development of hospital medical insurance work. Through regular medical insurance joint meetings, we will study and solve the problems and difficulties encountered in medical insurance work with the medical insurance department, and promote the continuous improvement and perfection of medical insurance work.
To sum up:
The work plan of hospital medical insurance department in 2024 aims to improve the level of hospital medical insurance work in an all-round way by optimizing the medical insurance service process, improving the quality of medical services, reducing the burden of patients' medical expenses and strengthening communication and cooperation with medical insurance departments. The implementation of these measures will help to better protect the rights and interests of patients, improve the comprehensive competitiveness of hospitals, and make contributions to building a harmonious society.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 27 provides that:
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Article 28 provides that:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.