2, master all kinds of medical insurance policies at all levels, in accordance with the medical insurance agencies at all levels approved medical items and payment standards for audit and settlement.
3, conscientiously do a good job of medical insurance inpatient expenses audit, all self-funded projects and expenses outside medical insurance coverage should be signed by patients or their families.
4, strict implementation of admission and discharge standards, do not decompose the number of hospitalized patients, do not shuffle critically ill patients, and do not harm the interests of insured workers.
5, strengthen the settlement and management of medical insurance expenses, timely contact with medical insurance agencies at all levels, coordinate and solve the problems in the settlement of medical insurance expenses.
6, in accordance with the requirements of medical insurance agencies at all levels to submit statements in a timely manner, and regularly check the payment with the financial sector, do a good job of sorting, binding and preservation of archival materials, and provide convenience for the audit of medical insurance expenses.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.