军队医院地方医保基金运行的智能监管实践  

Practice of Intelligent Supervision of Medical Insurance Fund Running in Military Hospital

作　　者：杨毕辉[1] 王继伟[1] 褚晓静[1] 李愉[1] 郑荣纬[1] 

机构地区：[1]解放军第174医院

出　　处：《中国数字医学》2015年第12期65-67,共3页China Digital Medicine

基　　金：军队医药卫生科技创新项目(编号:09MA059)~~

摘　　要：通过对军队医院地方医保基金运行风险监管系统的介绍,阐述了医院在医保管理中的诊疗行为过程监控、费用监控、医保基金使用风险控制等信息化管理实践。该系统的实施,杜绝了医保违规现象的发生,强化医保基金使用和医疗服务行为管控,提高了医院经济效益及医保信息化管理水平,实现了医院医疗保险管理的智能化、规范化、科学化。This paper described the hospital use the medical insurance fund information management in the treatment behavior process monitoring,cost control,risk control,throughout the description of medical insurance fund operation risk supervision system in military hospital.Implementation of the system,it＇s going to eliminate the medicare irregularities,strengthen the use of medical insurance fund and the control of medical services,improve the economic efficiency of the hospital and medical insurance information management level,achieve the intelligent,standardized and scientific management of hospital medical insurance.

关 键 词：医保基金 智能监管 军队医院 

分 类 号：R319[医药卫生—基础医学]