预约电话：0791-87655800 二、南昌市 今年春节假期，江西省各级医保经办机构将持续为大家提供延时预约服务。我们整理了省本级及11个设区市本级医保经办机构的值班安排供广大网友参 考，方便大家合理安排时间办理业务。 一、省本级 服务时间：2月15日-2月18日9:00-12:00；2月19日-2月23日9:00-12:00、13:30-17:00。 办理地址：南昌市红谷滩区北龙蟠街993号方楼省政务服务中心4层 服务时间：2月16日-2月18日9:00-12:00；2月15日、2月19日-2月23日9:00-12:00、13:30-17:00。 办理地址：南昌市红谷滩区北龙蟠街993号圆楼市政务服务中心三层东厅 服务电话：0791-12345 三、九江市 服务时间：2月15日-2月16日、2月18日-2月23日9:00-12:00、13:30-17:00。 办理地址：九江市八里湖新区体育路66号九江市政务服务中心二楼-医保窗口 服务电话：0792-8586309、8121135 四、景德镇市 服务时间：2月15日9:00-12:00、14:00-17:00；2月16日-2月18日9:00-12:00；2 ...

中国医保，一生守护！维护医保基金安全，人人有责！打击欺诈骗保举报电话：010-89061396，010- 89061397；邮箱：jubao@nhsa.gov.cn。 近年来，国家医保局积极推进智能监管体系建设，以现代信息技术赋能医保基金使用监督管理，着力构 建事前事中事后相结合、全流程全领域全链条的智能监管体系，切实守护好老百姓的"看病钱""救命 钱"。一方面，赋能各级医保行政部门和经办机构，针对医保基金使用点多、面广、线长、量大的实际 情况，通过大数据和人工智能等监管方式，提高医保基金事中审核和事后监管的效能，破解人少事多的 难题。另一方面，赋能广大定点医药机构，积极推动事前提醒在定点医药机构落地应用，在医务人员诊 疗过程中即可实现对违反刚性约束类基金使用规定的违规行为进行自动提醒、预警和拦截，帮助医务人 员更好了解和掌握医保基金监管规则，助力定点医药机构提升自我管理。 为推进监管关口前移，不断强化事前提醒、事中审核、事后监管，筑牢智能监管三道防线，国家医保局 主动公开智能监管规则，2025年以来，已通过官方网站向社会公开发布8批监管规则和近2万条知识点。 此次出版发行《医疗保障基金智能监管规则库、知识库 ...

Core Viewpoint - Shandong Province is actively exploring the construction of "Personal Medical Insurance Cloud" to transform vast medical insurance data into warm services for citizens, enhancing accessibility and understanding of their rights and benefits [1] Group 1: Yantai Practice - Yantai City has launched the "Personal Medical Insurance Profile" service, integrating fragmented medical insurance information into a dynamic, visual personal insurance overview, serving 32,000 users since its launch [2] - The service provides a clear timeline of insurance status, real-time account balance updates, categorized spending analysis, and a comprehensive annual report of benefits, enhancing user experience [2] Group 2: Weifang Practice - Weifang City has developed an "Intelligent Central Hub" with over 180 precise labels for personalized service, transitioning from passive reception to proactive support for insurance beneficiaries [4][6] - The system automatically alerts users about benefits and health monitoring, focusing on key demographics like newborns and the elderly, and incorporates AI for 24/7 customer service [6] Group 3: Jinan Practice - Jinan City has implemented AI technology to create a "Smart Medical Insurance Assistant," utilizing 289 feature tags to understand user needs and streamline service delivery [7][9] - The city has introduced 23 proactive service scenarios, significantly improving user interaction and reducing processing times for benefits, with a projected outreach of 220,000 service messages by 2025 [9] Group 4: Overall Insights - The three cities' distinct approaches—Yantai's clear visualization, Weifang's proactive service, and Jinan's AI integration—collectively illustrate a pathway for upgrading medical insurance services in Shandong Province [11] - These innovations have notably increased service efficiency and user satisfaction, transforming the vision of "data doing the running" into a tangible reality, enhancing citizens' sense of security and well-being [12]

Core Insights - The National Healthcare Security Administration (NHSA) aims to address issues in medical payment processes through collaborative efforts from various sectors, including enterprises, universities, research institutions, and medical organizations [1] Group 1: Medical Payment Innovations - NHSA plans to create a dynamic repository of actual needs and challenges in the healthcare sector, encouraging public participation in proposing solutions [1] - Initial focus areas include reducing the hassle of multiple queues for payments, with an emphasis on promoting convenient payment methods such as facial recognition, credit payments, and mobile payments [1] - The goal is to streamline the payment process for patients, potentially allowing them to pay after leaving the hospital [1] Group 2: Medical Imaging Solutions - NHSA is working on establishing a nationwide medical imaging cloud network to facilitate the quick retrieval of medical images across provinces, addressing the inconvenience of carrying physical film for patients [1] - This initiative not only benefits patients but also provides opportunities for innovation and application for companies involved in medical imaging [1] Group 3: Personal Health Services - NHSA is set to promote the development of a "Personal Medical Cloud" that includes personal health records, which could enhance health management and wellness services through artificial intelligence [2]

据国家医保局官网消息，近日，国家医保局印发《关于加快医疗保障领域场景培育和开放 支持新场景 大规模应用的通知》(以下简称通知)，明确医疗保障领域场景培育和开放的相关要求，营造全社会共同 参与场景应用的良好环境，更好统筹贯通医疗保障保健康与促发展功能。 通知从总体要求、重点任务、保障措施三个部分，构建起完善的医疗保障领域场景培育、开放和应用的 工作机制，主要内容概括为"四个坚持"。 一是坚持需求导向。 二是坚持开放合作。 明确鼓励符合条件的各类企业、高校、科研院所、医疗机构、商业健康保险机构、职工互助保障组织、 慈善组织等共同参与医保领域场景应用。医保部门将加强场景宣传推介，积极支持各相关主体与创投机 构、产业基金、商业银行等沟通合作，助力社会发现真创新、支持真创新。在确保安全的前提下，依法 有序开放数据，丰富政策工具供给，推动场景应用与数智医保建设相衔接，为场景应用提供广阔空间。 医保部门将紧紧围绕群众需求和医保改革需要，常态化征集涉及医疗医药技术进步、便民服务优化、管 理能力提质、跨领域协同增效、医保综合价值评价等方面的场景，动态更新医保领域场景库。鼓励地方 医保部门结合本地实际，提出能够体现区域特色、解决 ...

Core Viewpoint - The article highlights the successful resolution of a unique case where a foreign resident in Jining, Malaysia-born Zhang Zhenhan, was able to use the medical insurance electronic voucher for the first time in Shandong Province, showcasing the extension of medical insurance services to a broader demographic [2][6]. Group 1: Case Background - Zhang Zhenhan, a Malaysian national living in Jining for over ten years, faced difficulties using his medical insurance electronic voucher at a pharmacy due to mismatched identity information in the system [3][4]. - Despite having paid into the medical insurance system for years, Zhang encountered issues when attempting to use the electronic voucher for medication, which he found convenient compared to traditional methods [3][6]. Group 2: Problem Resolution - The staff at the medical insurance window, including Li Shuai, coordinated with various stakeholders, including the National Medical Insurance Center and a third-party technical company, to address the issue [4][5]. - A WeChat group was created to facilitate communication among all parties involved, allowing for real-time updates and problem-solving [5][6]. - After identifying that the issue stemmed from the standardization of Zhang's name in the system, adjustments were made, but further complications arose due to the pharmacy's electronic prescription system not recognizing foreign identification types [6][7]. Group 3: Successful Outcome - Ultimately, the issues were resolved by mid-December 2025, allowing Zhang to successfully use the electronic voucher for a medication purchase, marking a significant milestone as the first case of a foreigner using the medical insurance electronic voucher in Shandong [6][8]. - Zhang expressed gratitude for the attentive service provided by the medical insurance staff, highlighting the importance of such services for foreign residents [6][8]. Group 4: Broader Implications - The case illustrates the ongoing efforts to create a more inclusive medical insurance network in China, extending services to foreign residents and enhancing their sense of belonging in the community [7][8]. - Zhang's commitment to promoting a more civilized and convenient environment in Jining reflects the broader goals of the local government to improve public services and integrate foreign residents into the community [8].

临沂市医保局聚焦参保人"垫资压力大、报销跑腿烦"的核心痛点，全力推进异地就医联网直接结算服 务。目前，全市已与全国31个省份、8万余家定点医疗机构实现联网，参保人持激活的社保卡或医保电 子凭证即可实现费用直接结算，直接结算范围逐步从住院拓展到普通门诊和高血压、糖尿病等10种门诊 慢特病，惠及更多参保人员。同时，聚焦群众实际需求，稳步增加异地联网定点医药机构数量，目前， 全市共开通省内及跨省住院费用、普通门诊费用、门诊慢特病费用联网结算医疗机构453家、767家、 260家。 齐鲁晚报.齐鲁壹点李其峰 构建服务网络，打通宣传末梢 随着人口流动加速和群众就医需求日益多元化，异地就医结算服务已成为医疗保障体系的重要环节，结 算便捷度直接影响着参保人就医体验。近年来，临沂市医保局立足群众实际需求，通过优服务、强宣 传，持续提升异地就医政策知晓度及直接结算便捷度，让"人在异乡、病有所医"从承诺变为现实。 持续推进异地就医群众精准服务，对于通过电话备案人员，备案时主动告知外出就医注意事项和联网结 算相关政策；对于门诊慢特病跨省就医人员，及时排查其慢病信息是否上传。用服务"先一步"换群 众"少跑腿"，让参保人感受到"异地就 ...

活动开展过程中，"湘医保健康增值服务联盟"将持续扩大合作范围，积极丰富服务内涵，推动医保服务 从"保疾病"向"促健康"延伸，让更广泛、更可及、更优惠的健康服务惠及广大人民群众。（段澄梦） 编辑：胡晨曦 1月23日下午，湖南省医保局、中国银行湖南省分行在长沙联合召开"湘医保健康增值服务参保送福袋活 动发布会"。湖南省医保局、中国银行湖南省分行有关领导，各市州医保局及中行分支机构、首批联盟 成员单位代表参加了发布会。 由湖南省医保局和中国银行湖南省分行携手发起的"湘医保健康增值服务联盟"，已吸引全省数千家机构 和门店加盟，将依托"湘医保"服务平台和"云闪付"中银权益专区提供丰富多元的健康增值服务。首 期"参保送福袋活动"向全省参保人发放的健康福袋中，包括了体检、眼科、口腔、购药、运动健身等5 大类共14张优惠券。湖南省基本医保参保人只需实名登录"湘医保"公众号或者App，即可进入"医保健 康增值服务"专区领取健康福袋中的优惠权益。其中，体检、眼科类优惠券可在"湘医保"中直接使用， 其他口腔、购药、健康消费类优惠券可通过"云闪付"中银权益专区查询使用。 转自：新华财经 ...

编辑：联盟菌 1月8日，中国政府采购网发布了《甘肃省医疗保障局2025年基金监管工作购买第三方专业机构服务项目(二次)中标（成交）结果公告》，标志着新一轮省 级医保基金检查正式启动。 | 财政部唯一指定政府采购信息网络发布媒体 国家级政府采购专业网站 | | | | 服务频在:400-810-1996 | 服务论证:010-63819289 | | --- | --- | --- | --- | --- | --- | | 中国 政 府 示 财 网 | | | | | | | 中国政府财实服务信誉变得 | | | | | | | www.ccgp.gov.cn | | | | | | | 首页 | 政采法规 | 购买服务 | 监督检查 | 信息公告 | 国际专栏 | | 当前位置： 首页 » 政采公告 » 地方公告 » 中标公告 | | | | | | | 甘肃省医疗保障局2025年基金监管工作购买第三方专业机构服务项目(二次)中标 | | | | | | | (成交) 结果公告 | | | | | | | 2026年01月08日 11:45 来源：中国政府采购网甘肃分网 【打印】【显示公告概要】 | | | ...

Core Insights - The article discusses the efforts of Weihai's Medical Insurance Bureau to enhance the convenience and coverage of medical insurance services, aligning with the State Council's directive for efficient service delivery. Group 1: Service Optimization - The implementation of a "one-stop" service model in the medical insurance sector includes a list of 25 key services, enabling integrated processing of related matters, such as automatic approval of retirement medical insurance benefits through data sharing with the provincial social security system [1] - The "immediate enjoyment" of medical insurance benefits is facilitated through data analysis that matches eligible insured individuals and enterprises, allowing over 60,000 people to benefit without needing to apply actively during the 14th Five-Year Plan period [1] Group 2: Digital Transformation - The introduction of online channels, including the "Love Shandong" app and "Weihai Medical Insurance" mini-program, allows for the online processing of 27 medical insurance service items, promoting the use of electronic medical insurance certificates for seamless hospital visits [2] - The expansion of cross-province direct settlement services for medical insurance enables residents to register online and settle medical expenses directly at designated medical institutions without upfront payments [2] Group 3: Localized Service Delivery - The establishment of a "15-minute medical insurance service circle" aims to meet the demand for convenient local services, integrating a system that connects various service points from city to village levels, ensuring comprehensive coverage [3] - The creation of 293 medical insurance workstations and 565 service points allows for the provision of 18 high-frequency medical insurance services within close proximity to residents, facilitating over 100,000 transactions annually [3]