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What are the responsibilities of medical insurance audit?

Being a public institution, its main responsibilities are as follows:

(1) Being responsible for the preparation, management, payment and audit of the budget and final accounts of the medical insurance fund in this Municipality.

(2) To be responsible for the personal account management of medical insurance and the settlement and payment of funds in this Municipality.

(3) to be responsible for the review, settlement and medical treatment management of social insurance medical expenses in this overall planning area.

(4) to be responsible for the management of free medical care and the review, settlement and medical treatment management of basic (subsidized) medical expenses for civil servants in this Municipality.

(5) To be responsible for the organization and implementation of the new medical reform plan, and the settlement of medical expenses and medical management services for insured persons in non-co-ordination areas in this city.

(6) signing medical service agreements with designated medical and pharmaceutical institutions of social insurance, and conducting relevant policy propaganda and business training; Assist the administrative department of labor and social security to guide, supervise, inspect, regularly evaluate and assess the implementation of policies and regulations and medical service agreements of designated medical and pharmaceutical institutions, and implement resident supervision and management of designated medical institutions; Responsible for the audit of bookkeeping medical expenses in designated medical and pharmaceutical institutions.

(7) to be responsible for supervising and inspecting the specific outpatient items handled by the secondary handling institutions, as well as the business matters such as second return to hospital, referral and transfer, and examination and approval of medical treatment in different places.

(8) to be responsible for the compilation of service standards, regulations and publicity materials for the management of social insurance medical services, provide inquiry and consultation services for related businesses, and accept relevant complaints.

(9) responsible for the requirements and testing of the social insurance medical business information system, and responsible for the construction of standard database and data management and maintenance.

(1) organize and participate in the investigation and statistical analysis of social insurance medical services and related policies.

(eleven) responsible for the overall planning, command and management of the secondary medical insurance agencies.

Further reading: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.