转自：广西贺州政府网 近年来，贺州市积极响应国家医保基金监管数字化转型号召，以创新为引领、科技为支撑，围绕医保基金监管数字化转型目标，探索创新监管模式，大力 推进医保智能监管与智能场景监控"双智融合"应用。这一举措为医保基金监管注入智慧动力，推动医药机构优化服务流程、规范诊疗行为，初步实现医保 基金监管从"事后追责"向"事前防范"、从"粗放管理"向"精准治理"的跨越，更好守护医保基金安全防线。如今，贺州市智能监控系统接入率、场景覆盖广 度居全区前列，成功入选国家智能监管改革试点地区，成为医保基金监管领域的"排头兵"。 图为医保智能场景监控系统 目前，全市已有174家定点医药机构完成智能场景监控建设并常态化运行。系统启用以来，挂床住院、冒名就医等现象得到有效遏制，累计发现住院期间 请假不在床0.34万人次，拦截冒名就医5起，阻断不合理医疗费用约28.84万元。康复理疗领域也日趋规范，36家医疗机构主动退费重结384笔，涉及金额 1.94万元。 试点先行，树立行业新标杆 智能拦截，风险防范在源头 "系统一提醒，我们就知道哪里可能存在问题，及时调整，既规范了诊疗，也保护了基金安全。"在贺州市一家定点医院，医生对医保 ...

Core Insights - The focus of the news is on the implementation and effectiveness of the medical insurance intelligent monitoring system at Tai'an First People's Hospital, which aims to enhance the regulation of medical insurance funds and improve service quality for patients [1][3][5]. Group 1: Implementation of Intelligent Monitoring System - The Tai'an First People's Hospital has adopted an intelligent monitoring system for medical insurance, which includes AI video monitoring and various smart devices to oversee inpatient, outpatient, and dialysis scenarios in real-time [3]. - The monitoring system has demonstrated its practicality and convenience through the use of handheld mobile terminals, smart thermometers, and medical service terminals [3]. Group 2: Regulatory Improvements - The hospital aims to standardize medical practices by integrating medical insurance regulation throughout the entire process of medical care, management, and service [5]. - A comprehensive regulatory network will be established through collaboration across multiple departments, employing a full-chain regulatory model that includes pre-warning, in-process reminders, and post-analysis [5]. Group 3: Goals and Outcomes - The initiative seeks to transition from passive to proactive regulation of medical insurance funds, ensuring comprehensive monitoring of fund usage to prevent losses [5]. - The ultimate goal is to provide fair, just, intelligent, and efficient medical insurance services to insured patients while promoting high-quality management within the hospital [5].