Analysis on the filing mechanism for cross provincial immediate reimbursement of medical insurance in China
10.3760/cma.j.cn111325-20201229-02269
- VernacularTitle:我国基本医保跨省异地就医直接结算备案政策分析
- Author:
Xiaotong JIANG
1
;
Minjiang GUO
;
Yazi LI
;
Yang LIU
;
Chunji LU
;
Chi ZHANG
Author Information
1. 中国医学科学院医学信息研究所，北京 100020
- Keywords:
Insurance, health, reimbursement;
Basic medical insurance;
Cross provincial immediate reimbursement;
Filing mechanism
- From:
Chinese Journal of Hospital Administration
2021;37(8):636-641
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the filing mechanism for cross provincial immediate reimbursement of medical insurance in China, so as to provide reference for optimizing the filing mechanism and improving the filing accessibility of insured personnel.Methods:Taking the filing policy of cross provincial immediate reimbursement of medical insurance in 2019 as the research object, on the basis of a comprehensive understanding of the national filing policy background, 90 coordinating regions in Zhejiang Province, Hubei Province and Ningxia Hui Autonomous Region were taken as survey samples to evaluate the relevant policies and extract key parameters, including filing identification methods, filing-related settlement benefits and filing ways. The parameters were compared and analyzed by using descriptive statistical methods.Results:The results of the survey showed that in terms of identity recognition methods, the provision of various supporting materials(residence permit, work certificate, etc.)was still the main way to carry out identity recognition for medical insured persons in different places.Filing-related reimbursement benefits were mainly adjusted by limiting the area of medical insurance treatment and adjusting the benefits parameters(reimbursement ratio). In terms of filing channels, 51(56.7%)sample co-ordination areas had realized at least one remote filing mode.Conclusions:The inclusiveness of filing identity verification mechanism for the floating population needs to be further improved, the filing-related treatment policies need to be further improved, and the convenience and standardization of filing channels need to be strengthened.
