1, set up a hospital medical insurance management team to work under the leadership of the dean. Set up a medical insurance office, equipped with 1 full-time (part-time) management personnel to be responsible for the medical insurance work in our hospital;

2, formulate medical insurance management methods and specific assessment methods, medical insurance office has a clear job responsibilities, and a sound internal management system and corresponding measures suitable for medical insurance management;

3. Establish a medical insurance management network and implement relevant medical insurance rules and regulations. Responsible for the regular standardization, coordination, assessment and supervision of medical insurance business and medical behavior, and conduct regular self-examination, spot check, assessment, monitoring and analysis of outpatient prescriptions, discharge medical records, admission and discharge standards and discharge medication;

4, standardize the medical behavior, conscientiously implement the medical insurance policies and regulations, and sign the medical insurance designated service agreement with the municipal medical insurance center on time, and perform the corresponding rights and obligations in accordance with the provisions of the agreement;

5. Strictly implement the medical technical operation specifications, medical record management and related business policies stipulated by the health administrative department, and conduct reasonable inspection, rational drug use and reasonable treatment.

Legal basis: Article 4 of the Interim Measures for the Administration of Medication in Basic Medical Insurance.

Medication management of basic medical insurance adheres to the people-centered development concept, and effectively guarantees the rational drug use needs of insured persons; Adhere to the functional orientation of "ensuring basics", do your best and do what you can, and the level of drug protection is compatible with the basic medical insurance fund and the affordability of the insured; Adhere to hierarchical management, clear responsibilities and authority at all levels; Adhere to expert evaluation, adapt to the progress of clinical technology, and realize scientific, standardized, refined and dynamic management; Adhere to both Chinese and western medicine and give full play to their respective advantages.