青海“智慧医保”建设提速

Core Insights - The healthcare insurance department is focused on optimizing medical insurance services to address public concerns and improve efficiency in the sector [1][2] Group 1: Enhancements in Medical Insurance Services - The initiative includes advancing "smart medical insurance" construction, enhancing information platform functionalities, and streamlining business processes [1] - The promotion of digital applications such as electronic medical insurance credentials and mobile payments aims to expand the coverage of "face recognition" settlement [1] - The optimization of online business processes and the enhancement of cross-province personal account usage are key objectives [1] Group 2: Improvement in Service Capabilities - The implementation of a clear list of medical insurance service items and the standardization of service processes and timelines are prioritized [1] - The establishment of standardized service windows and demonstration points is part of the effort to improve service efficiency [1] - The initiative includes a targeted training program for staff to enhance their capabilities and ensure they meet the needs of the public [1] Group 3: Timely Settlement Capabilities - The focus is on optimizing the settlement process with designated medical institutions, improving review processes, and enhancing data integration [2] - Aiming for a settlement timeline where expenses are reported in the current month and settled in the following month [2] - The establishment of a three-tiered monitoring mechanism for real-time oversight of fund settlement and disbursement is being explored [2] Group 4: Data Security and Efficiency - The integration of medical insurance with commercial health insurance and charitable assistance for a one-stop settlement process is being promoted [2] - Emphasis on data security while enhancing the efficiency of multi-level medical insurance settlements through improved verification processes [2] - Strict measures are in place to ensure fund security and prevent fraudulent claims while supporting the healthy development of medical institutions [2]