Comprehensive promotion! From "post-payment system" to "instant settlement" Medical insurance settlement in many places has accelerated

Since last year, medical insurance settlement in many places has been accelerated, effectively solving the problem of poor capital flow in the pharmaceutical industry and effectively promoting the healthy and sustainable development of the pharmaceutical industry.

Anhui is the first in the country to realize instant settlement in the province, with the payment deadline for medical insurance funds being shortened to about one working day; Jiangxi has directly settled 9.042 billion yuan in more than 3,500 pharmaceutical suppliers in 2024, and the settlement period for the payment of goods has been reduced from 6 months to about 30 days; Shandong Province launched an integrated synchronous settlement platform for medical insurance and commercial insurance to improve claims efficiency and reduce the economic burden of patients.

Yancheng, the first batch of Jiangsu cities to carry out the "instant settlement" pilot work, achieved "instant settlement" between the medical insurance department and medical institutions in less than a month. At Yancheng Medical Insurance Bureau, the reporter saw that staff were checking the medical expenses incurred by municipal medical institutions the day before through the National Medical Insurance Information Platform.

Zhang Yan, head of the Fund Settlement Section of Yancheng Medical Insurance Fund Management Center: It turns out that our settlement with medical institutions is a postpayment system, and the review and allocation of expenses for the previous month will be completed within 20 working days of the following month. After real-time settlement is implemented, the previous day data is automatically solidified every day and allocated in a certain proportion, which increases the frequency of payment of fees. We allocate the medical expenses incurred yesterday, and medical institutions can check the settlement amount through the two-determined institutional exchange platform.