多举措推动 商业医疗保险高质量发展

Core Insights - The Financial Regulatory Bureau has released responses to proposals from the 14th National Committee of the Chinese People's Political Consultative Conference and the 14th National People's Congress, focusing on the development of commercial health insurance and enhancing service efficiency [1][2] Group 1: Enhancements in Claims Processing - The bureau emphasizes the importance of improving insurance claims services and is taking multiple measures to enhance efficiency [1] - There is a focus on strengthening communication with relevant departments to promote the interconnectivity of insurance, medical, and health insurance information systems [1] - The bureau is working with the National Healthcare Security Administration to include information sharing between medical insurance platforms and commercial health insurance in the "14th Five-Year" National Medical Security Plan [1] Group 2: Standardization and Guidelines - The China Insurance Industry Association is being guided to develop unified claims service standards to elevate industry claims levels [1] - A new "Life Insurance Claims Service Specification" will be released in November 2024, establishing clear standards for claims services and evaluations [1] Group 3: Integration of Health Insurance and Medical Services - The bureau is prioritizing the integration of commercial health insurance with medical and pharmaceutical data to enhance patient service experiences [2] - In cities like Dalian and Chengdu, direct settlement of medical expenses between insurance companies and medical institutions has been implemented, significantly improving claims efficiency [2] - However, the current level of direct settlement between insurance companies and hospitals remains low, with limited insurance product coverage [2]