Research On The Settlement Of Medical Expenses For Medical Insurance In Shanghai

With the development of China’s economy,increasingly close exchanges between regions and between regions,increasing floating,the growing number of injured personnel,work-related injury insurance in different places growing demands of medical personnel.All and manpower area according to national injury insurance ordinance gradually developed has related of local of implementation approach and operation rules,but always no a unified of,and perfect of injury insurance offsite medical service management policy and settlement approach,injury personnel in offsite medical of process in the and handle offsite medical claims of process in the,appeared has not fair,not convenient of phenomenon,caused injury insurance handling institutions provides of service and offsite medical personnel needs of contradictions is highlight.This paper discusses work-related injury insurance theory,combined with medicare medical settlement of relevant approaches and experiences in different places in Shanghai,the Shanghai long-distance medical costs of industrial injury insurance settlement status and characteristics are summarized.Through the analysis of real cases,operate on the counter method of random interviews,analyzed off-site medical costs of industrial injury insurance problems and reasons of settlement.And the successful experiences of Shanghai medical insurance offsite medical clearing,clearly solve the plight of off-site for treatment of industrial injury insurance settlement,there are feasible options: the establishment of a unified work offsite medical clearing standards,to set up an independent industrial injury insurance agencies and independent models and collaborative model,establish a national information sharing mechanism,leading to injuries offsite medical settlement achieve the goal of interconnection settlement.