医院医保办对异地医保结算的战略  

Strategy of Hospital Medical Insurance Office for Medical Insurance Settlement in Off-site

作　　者：张娜[1] 

机构地区：[1]中国医学科学院肿瘤医院,北京100021

出　　处：《中国卫生产业》2017年第26期103-104,共2页China Health Industry

摘　　要：异地就医是指那些已经对基本医疗保险已经投保的人员,由于工作、旅游、转诊等原因所导致的在参保所归属地区以外的医疗机构进行就医或是购买药品的行为。异地医保结算是各个不同的医疗规划区域通过机构委托的方式进行联网结算,或者是通过和不同于本地的医疗结构合作的方式,从而达到就医人员的医疗保险费用报销效果,使异地医疗的水平得到充分的保障。近年来,由于人口的流动率和人们的医疗保险意识不断的提高,就造成异地就医的需求率大大增加,但另一方面,面临的问题也逐渐增多。国务院等相关机构也提出一系列的实施方案来不断改善并完善异地医保结算的机制。Off-site medical treatment refers to a group of people who have been insured on the basic medical insurance,due to work, travel, referral and other reasons caused by the insured in the area outside the medical institutions for medical treatment or purchase of drugs. Outside the medical insurance settlement is a network settlement of different medical planning area through the agency or through cooperation with different medical structure, so as to achieve medical insurance reimbursement effect of medical treatment, so that the level of remote medical treatment can be guaranteed. In recent years,due to the population turnover rate and the improvement of people's awareness of medical insurance, a large increase in demand for medical treatment off-site, but on the other hand the problems were gradually increasing. The State Council and other relevant agencies had also proposed a series of implementation programs to continuously improve the mechanism of off-site medical insurance settlement.

关 键 词：医保办 异地 医保结算 

分 类 号：R197[医药卫生—卫生事业管理]