【摘要】 结合当前全民医保的形势,某三级甲等医院从多个方面对医疗保险投诉的原因进行分析:主要有患者对医保政策不了解、沟通不到位;医护人员对医保政策掌握不全,患者权益未得到保障;患者对门诊就诊、退费流程不熟悉;对窗口工作人员的服务态度不满意等方面,并提出管理中要一宣传、二培训、三考核、四完善、五沟通的一条龙服务措施:强化对医保政策规定的宣传力度;加强对医护工作人员的教育、培训;提高医保工作人员的服务意识和服务质量;完善信息管理系统,努力为参保人员提供方便等应对策略,以强化医院管理,有效降低了医保的投诉率,提高了患者满意度。更多还原

【Abstract】 In combination with the current situation of medical insurance for the whole society,the causes of medical insurance complaints were analyzed in Grade ⅢA hospital.The main reasons were: the patients are not aware of the medical insurance policy,poor communication; the medical and nursing staff are not fully aware of the medical insurance policy,and the rights and interests of the patients are not guaranteed; the patients were unfamiliar with the outpatient and the refund process; do not satisfy with the service attitude of the window staff.Than,the one dragon service measures should be put forward in the management of a propaganda,two training,three assessment,four perfect and five communication: strengthen the publicity of the medical insurance policy,strengthen the education and training of the medical staff and improve the service of the medical workers.In order to strengthen the management of the hospital and reduce the complaint rate of medical insurance and improve the patient satisfaction.更多还原