医疗保险待遇纠纷分析——以山东省为例  

Analysis of Medical Insurance Treatment Dispute--Taking Shandong Province as an Example

作　　者：闫召祥 率园园 郑丽丽 吴月 丁友房 

机构地区：[1]菏泽市定陶区医疗保障局,菏泽274199 [2]山东二叶制药有限公司,菏泽274199 [3]菏泽市医疗保障局,菏泽274000 [4]扬州市江都区人民法院,扬州225200

出　　处：《中国医疗保险》2022年第11期80-83,共4页China Health Insurance

摘　　要：医疗保险待遇纠纷是指医疗保险关系当事人之间因医疗保险关系的建立和医疗保险待遇的实现所产生的矛盾。目前国内关于医疗保险待遇纠纷方面的研究较少。本文以山东省医疗保险待遇纠纷案件为样本,通过现状介绍、特征分析、待遇纠纷预防等角度进行研究,以期为医保经办机构和相关部门提供建议。Medical insurance treatment dispute refers to the contradiction between the parties of medical insurance relationship due to the establishment of medical insurance relationship and the realization of medical insurance treatment.At present,there is few researches on the dispute of medical insurance treatment in China.This paper takes medical insurance treatment dispute cases in Shandong Province as samples,analyzes from the introduction of the current situation,characteristics analysis,treatment dispute prevention and other perspectives,in order to provide suggestions for medical insurance agencies and related departments.

关 键 词：医疗保险 待遇纠纷 稽核 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]