Discussion on the Reasons and Countermeasures of Medical Insurer Refusing to Pay Hospitals：Taking a tertiary hospital as a case study / 中国卫生经济

ABSTRACT

Objective:To put forward rational suggestions of how to reduce the protest in medical insurance cases from two aspectshospitals and medical insurance agencies, to provide reference for strengthen management of designated hospitals and Medical Insurance Center. Methods:Taking a tertiary hospital of Beijing as an example, summarizing the basic situation of protest in medical insurance and analyzing several kinds of cases, making thorough analysis of deep-seated reasons which caused the protest in medical insurance and finally put forward rational suggestions. Results: The protest in medical insurance is not only caused by hospitals, the Medical Insurance Center should also take certain responsibilities. Conclusion: Hospitals and Medical Insurance Center should all take corresponding measures to reduce the protest in medical insurance cases.