在服务提质方面，广阳区坚持以群众需求为导向，不断优化医保服务流程，提升服务效能；整合医保服 务资源，在各镇、街道服务大厅设立医保服务窗口，实现参保登记等3大类15项医保高频服务事项下沉 办理。同时，该区积极推进"互联网+医保服务"，群众通过手机APP、微信公众号等渠道，即可办理参 保缴费、异地就医备案、医保电子凭证激活等业务，真正实现了"让数据多跑路，群众少跑腿"。此外， 该区还加强了医保服务队伍建设，开展业务培训和技能提升活动，提升工作人员的服务意识和业务水 平，进一步提升群众对医保服务的满意度和获得感。 （来源：廊坊日报） 转自：廊坊日报 本报讯（记者 王满凤 通讯员 王峻峰）近日，记者从广阳区召开的新闻发布会上获悉，近年来，广阳区 牢牢紧扣"扩面、提质、强保障"的工作主线，推动全区基本医保参保工作取得了一系列阶段性成果。该 区基本医保参保率持续稳定在95%以上，基本实现了常住人口全覆盖。 在参保扩面方面，广阳区聚焦"应保尽保、不漏一人"的目标，构建了"政府主导、部门协同、乡镇主 抓、村组落实"的四级联动工作体系；开展"全民参保攻坚行动"，针对流动人口、灵活就业人员、困难 群体等重点人群，建立了"精准排查 ...

Core Viewpoint - The article emphasizes the importance of regular supervision of medical insurance funds to ensure their safe operation, improve usage efficiency, standardize medical service behaviors, and reduce the burden on patients seeking medical care. Traditional regulatory methods are inadequate in addressing new types of violations arising from reforms in medical insurance payment methods, necessitating a shift towards intelligent auditing using big data and smart technologies [1][2][3]. Group 1: Development of Intelligent Auditing - The development of intelligent auditing has been guided by policies since 2018, with significant milestones including the promotion of real-time monitoring and strict regulation of medical behaviors [2]. - By 2023, the National Medical Insurance Administration aims to implement a nationwide intelligent monitoring system, with a goal of establishing a standardized and scientific auditing framework by the end of 2025 [2][3]. Group 2: Features of Intelligent Auditing System - The intelligent auditing system features a layered architecture that integrates diverse data sources, enabling real-time analysis and monitoring of medical expenses [4]. - A dynamic and flexible rule engine is central to the system, allowing for the adaptation of auditing rules based on evolving medical policies and practices [5]. Group 3: Impact on Medical Insurance Regulation - The intelligent auditing system significantly enhances the efficiency of medical insurance regulation, processing over 20 million cases daily with an accuracy rate exceeding 92% [7]. - It establishes unified standards and objective rules, improving the credibility and authority of medical insurance oversight [7]. Group 4: Governance and Collaboration - The system promotes a shift from external control to internal motivation for compliance among medical institutions, encouraging proactive adherence to regulations [8]. - It fosters a collaborative governance model where feedback from medical institutions can lead to the dynamic updating of rules, enhancing the system's accuracy and inclusivity [8]. Group 5: Enhancing Service Quality - Intelligent auditing improves settlement efficiency for insured individuals, enhancing their sense of satisfaction and security regarding medical services [10]. Group 6: Future Outlook - There is a need for improved policy interpretation and training for medical staff to ensure a better understanding of auditing rules and standards [11]. - Emphasis on data security and privacy protection is crucial, given the sensitive nature of medical insurance data [13]. - The establishment of relevant laws and regulations is necessary to support the legal and compliant application of intelligent auditing technologies [14].