City Medical Insurance Office Medical Insurance Audit Case Study

Medical insurance mainly provides a basic guarantee for the people.Therefore,the government attaches great importance to the development of medical insurance.However,in recent years,news about fixed-point medical institutions arranging medical insurance funds through illegal activities has appeared in an endless stream.The reasons have revealed that at present,China's medical insurance auditing lacks corresponding laws and regulations to provide clear guidance for its implementation,and it is difficult for the government and other relevant agencies and organizations to carry out effective remediation of medical insurance audits,resulting in failure to meet medical insurance audits.The needs of the modern medical insurance system have not achieved real results and have given criminals a chance.At the same time,as the government accelerates the development of the medical insurance system,the requirements for the quality of its audit work are more stringent.This shows that the medical insurance audit has become a catalyst for the further development of the medical insurance system.Only an efficient medical insurance audit will provide adequate protection for the development of medical insurance.How to change the status quo of medical insurance audit is the most urgent task for the rapid development of the medical insurance system.This article is divided into four parts,taking the case of LY City Medical Insurance Office to audit the medical insurance of HK Hospital as a case study.The first part of the introduction mainly introduces the research purpose and significance of this article,and elaborates the research ideas and research methods of this article.The second part explains the relevant situation of the LY City Medical Insurance Office and its medical insurance audit.It introduces the case of LY City Medical Insurance Office auditing and briefly explains the actual situation of the medical insurance auditing at that time.The third part carries on the case analysis and explains the problems in the auditing process of the LY City Medical Insurance Office.It also clarifies the deficiencies in the medical insurance office's audit work and analyzes the reasons for the in-depth analysis.The fourth part combines the external environment of the entire medical insurance system and its development needs,and proposes countermeasures and suggestions for the auditing work of the medical insurance office.The purpose of this paper is to help the LY City Medical Insurance Office identify and fill in gaps in the audit work,standardize its audit procedures,improve its auditing methods,and make it better perform medical insurance audit work.At the same time,it can attract the attention of scholars in this area of research,thus allowing more scholars to conduct in-depth research on the medical insurance audit work and make important guidelines for China's medical insurance audit work.In addition,it is hoped that through the analysis of this case,we can provide useful suggestions for the related departments of medical insurance auditing in other regions during the audit work,and make contributions to the soundness and growth of the medical insurance industry in China.