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医保拒付是当前一个敏感话题,我作为一名医保办公室的工作人员,对此深有感受。每次遇到医生,他们常会小心翼翼地问:“有拒付?有我吗?”。当得到的答复是否定时,我看到他们立即如释重负。北京市医保中心将定点医疗机构拒付金额占申报总金额的比例、拒付人次占申报总人次的比例作为对医院考核的重要指标之一。我院是一所二级综合医院,在2012年门诊拒付情况如下:
Medicare protest is a sensitive topic at the moment, and I feel deeply as a staff member in a Medicare office. Every time they meet a doctor, they often ask cautiously: “There are refusals? Have me??” When the reply I received was negative, I saw that they were relieved immediately. Beijing Medicare Center will be designated medical institutions to declare the amount of protest the total amount of the proportion of declarations, the total number of protest trips accounted for the total number of people as one of the important indicators of the hospital assessment. Our hospital is a two level general hospital, outpatient protest in 2012 as follows: