提高医保结算清单质量的探索与思考

医保结算清单是医保结算的统一凭证，也是DRG付费的核心要素。文章通过分析武汉市DRG试点医院“采集式”和“填报式”两种医保结算清单的特点和缺陷，思考将二者结合，探索由临床医生、病案部门、医保部门三者共同参与的结算清单闭环管理模式，旨在提高医保结算清单质量。

Exploration and Thinking on Improving the Quality of Medical Insurance Settlement List

Medical insurance settlement list is the unified voucher of medical insurance settlement and the core element of DRG payment. By analyzing the characteristics and defects of "collection" and "filling" medical insurance settlement lists in DRG pilot hospitals in Wuhan, this paper explored the closed-loop management mode of settlement lists involving clinicians, medical record departments and medical insurance departments, aiming to improve the quality of medical insurance settlement lists.