降低医疗保险拒付率  

Reduction of the Chargeback Rate of Medical Insurance

作　　者：苑记清[1] 范书南[1] 魏楠[1] 黄菁菁[1] 陈巨梅 

机构地区：[1]天津医科大学总医院,天津300052

出　　处：《中国卫生质量管理》2015年第2期77-79,83,共4页Chinese Health Quality Management

摘　　要：引入QC小组活动,遵循PDCA循环,使医疗保险拒付率由活动前的0.69%降低到活动后的0.37%。活动的开展,督促了医务人员合理使用统筹基金,降低了医保拒付率,保证了医保工作的良性运转。The inrroduction of QC group activities, follow the PDCA, the chargeback rate of medical insurance decreased from 0.69% to 0.37% after the activities. The QC group activities enhanced the rational use of the overall fund by medical per- sonnel, reduced the chargeback rate of medical insurance, ensured the healthy functioning of the health insurance.

关 键 词：医疗保险 拒付率 降低 

分 类 号：R197.1[医药卫生—卫生事业管理]