医保即时结算改革

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【榆林】在陕西首推医保“T+1”即时结算
Shan Xi Ri Bao· 2025-05-25 22:29
Core Points - The implementation of the "T+1" instant settlement system for medical insurance in Yulin City marks a significant advancement in the efficiency of medical fund settlements, reducing the settlement cycle from a maximum of 30 days to 24 hours [1][2] - The new system alleviates the financial pressure on hospitals by ensuring timely reimbursement, with the first transaction amounting to 278,400 yuan successfully credited to a hospital account [1] - Yulin City is one of the first pilot cities for the national basic medical insurance fund instant settlement reform, establishing a comprehensive "instant settlement" system that integrates various processes [1] Summary by Sections Instant Settlement System - Yulin City's medical insurance "T+1" instant settlement system has officially launched, allowing for next-day payments instead of monthly disbursements [1] - The system aims to enhance the efficiency of medical fund settlements and reduce the financial burden on healthcare institutions [1] Financial Impact - Prior to the reform, hospitals faced an average monthly advance payment of over 10 million yuan for medical insurance funds, which has now been significantly reduced [1] - As of now, 8 medical institutions in Yulin have completed instant settlement applications for a total of 3,471 cases, with medical expenses amounting to 34.62 million yuan and actual medical insurance fund disbursements of 10.27 million yuan [2] Integration with Other Insurance Programs - Since 2023, Yulin City has achieved a "one-stop" synchronous settlement for the Shaanxi Universal Health Insurance, basic medical insurance, major illness insurance, and medical assistance [2] - By the end of April this year, 90 medical institutions at the secondary level and above in Yulin City are capable of conducting synchronous settlements for the Shaanxi Universal Health Insurance [2]