Why does the Medical Insurance Bureau investigate hospitalization? The main reason why the Medical Insurance Bureau investigates hospitalization is to protect the fairness and rationality of medical insurance and to supervise the behavior of medical institutions.

The following are possible reasons: Ensuring the fairness and rationality of medical insurance: The Medical Insurance Bureau is responsible for managing and supervising the operation of medical insurance and ensuring the fairness and rationality of medical insurance.

Checking hospitalization can help the medical insurance bureau understand the patient's condition and treatment, thereby ensuring that medical insurance payment is reasonable and fair.

Supervise the behavior of medical institutions: The Medical Insurance Bureau can supervise the behavior of medical institutions through hospitalization inspections to ensure that the treatment and charges of medical institutions are standardized and reasonable.

If misconduct in a medical institution is discovered, the Medical Insurance Bureau can take appropriate measures to correct it.

Investigate medical fraud: The Medical Insurance Bureau can investigate medical fraud through hospitalization inspections, such as false treatments, false claims of expenses, etc.

These behaviors will seriously damage the fairness and reasonableness of medical insurance and therefore require investigation and handling.

Protect patients’ rights: The Medical Insurance Bureau can also protect patients’ rights by checking hospitalization, such as understanding their treatment plans, cost details, etc.

If patients have questions about treatment and costs, the Medical Insurance Bureau can help patients communicate and coordinate.

To sum up: The purpose of the Medical Insurance Bureau’s hospitalization investigation is to ensure the fairness and rationality of medical insurance, supervise the behavior of medical institutions, investigate medical fraud, and protect the rights and interests of patients.

This is the responsibility of the Medical Insurance Bureau, and it is also to maintain the normal operation of medical insurance and social justice.

Legal basis: Article 30 of the "Social Insurance Law of the People's Republic of China" stipulates: The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Those that should be paid from the work-related injury insurance fund; (2) Those that should be paid by the third party

Three people are responsible for the medical expenses; (3) The medical expenses should be borne by the public health department; (4) Medical treatment abroad is required.

Medical expenses shall be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first.

After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.