Yingshan, Sichuan: Weaving a dense medical insurance network to support the dream of health

In recent years, the Medical Security Bureau of Yingshan County, Nanchong City, Sichuan Province, has always kept in mind the heart of the early Republic of China, bravely shouldered the responsibility of benefiting the people, and implemented measures to benefit the people. It has focused on solving the pain points, difficulties, and bottlenecks of medical insurance services, continuously improving the medical security system and mechanism, and writing a warm and caring answer sheet for people's livelihood.

In 2024, a total of 14986 hospitalizations were reimbursed for employees in the county, and the overall fund settlement was 80.384 million yuan; Reimbursement of 160900 hospitalizations for residents and settlement of 543 million yuan from the overall fund; We paid a medical assistance fund of 67.0871 million yuan to people in need of illness, completed the settlement of 147201 people seeking medical treatment outside the city, and paid a medical insurance fund of 39.7053 million yuan.

Strengthening publicity to make medical insurance policies deeply rooted in people's hearts

On November 16th, every event in Huilong Town was crowded with people on the streets. Four medical insurance consultants from Langai Social Work Service Center in Yingshan County came to Huilongchang Town to provide thoughtful medical insurance policy promotion services to the masses. Not only did they distribute carefully prepared promotional materials to the public, but they also patiently and meticulously explained the 2026 medical insurance policy, including reimbursement ratios, reimbursement scope, insurance methods, and solutions to common problems, attracting many people to stop and listen.

Consultants tirelessly provide answers to the questions raised by the masses. Mr. Wu from Shiniu Village, Huilong Town happily said, "We don't usually know much about medical insurance policies. This promotional activity has made us clear how to use medical insurance and enhanced our understanding of the new medical insurance policies in 2026. In the future, we will have more confidence in seeking medical treatment

Not long ago, the medical insurance consultant of Langai Social Work Service Center went deep into Sanxing Community in Chengnan Street and other places, visiting more than 50 households with special difficulties. Focusing on the most concerning issues of medical assistance, hospitalization reimbursement, and outpatient treatment for special and disadvantaged groups, precise face-to-face explanations will be provided through the distribution of promotional brochures, on-site Q&A, case analysis, and other methods. I didn't expect the medical insurance policy to be so good. Many things I didn't understand before are now clear, "said Aunt Zhang from Samsung Community with emotion.

The medical insurance policy is not only the lifeline of safeguarding people's health, but also a key measure to enhance their sense of happiness. For this reason, the Yingshan County Medical Security Bureau has put in a lot of effort in publicity and training. We conducted a series of special training activities called "Medical Insurance Lecture Hall" and trained a group of "clear minded" and "difficult to understand" medical insurance policies in the medical insurance system, designated medical institutions, and insured units. In mid October this year, the bureau held four sessions of comprehensive medical insurance business training, covering four groups: grassroots medical insurance agencies, designated medical institutions, designated pharmacies, and medical insurance insured units. Tailored content modules were created based on the publicity responsibilities and audience characteristics of different groups, and a publicity pattern was constructed with "management personnel taking the lead in speaking, medical institutions actively promoting, and pharmacies and insured units participating together".

Yingshan County Medical Security Bureau also widely publicized the medical insurance policy by printing and distributing brochures, posting posters, radio, television, and WeChat official account, SMS, and short video platforms. Continuously carry out the "six in" campaign of introducing medical insurance policies into communities, schools, hospitals, enterprises, rural areas, and government agencies, and bring medical insurance policies to the people.

Grasp together, manage together, guard well, and make good use of the people's "life-saving money"

In order to effectively safeguard the safety of the medical insurance fund and the legitimate rights and interests of the people, and to crack down on fraudulent and fraudulent activities in accordance with the law and regulations, we are now publicly soliciting clues on the illegal and irregular use of medical insurance funds from the society. The reported content includes: reselling returned drugs, illegally prescribing excessive drugs, and cheating on maternity allowances... After verification, the informant will be rewarded according to regulations. "On October 20th, the Medical Security Bureau of Yingshan County issued a notice on publicly soliciting clues on the illegal and irregular use of medical insurance funds from the society, calling on all sectors of society to actively participate in supervision, curb illegal and irregular use of medical insurance funds from the source, and jointly protect the" medical money "and" life-saving money "of the masses.

We are committed to enriching and improving the channels for reporting and complaining, implementing a reward system for reporting, and mobilizing the enthusiasm of the whole people to participate in the supervision of the use of medical insurance funds. We will continue to expose typical cases and strengthen warning and deterrence. We will explore the system of disclosing the use of medical insurance funds by designated medical institutions to the society, and encourage the whole society to participate in the supervision of medical insurance funds, "said Li Hong, Secretary of the Party Group of Yingshan County Medical Security Bureau.

In recent years, the Medical Security Bureau of Yingshan County has always adhered to zero tolerance, heavy handed measures, and strict crackdowns. It has incorporated the supervision of medical insurance funds into the comprehensive supervision system of the whole society, forming a comprehensive supervision pattern that combines party and government leadership, social supervision, and industry self-discipline, with legal protection, regular inspections, and intelligent audits as the basis, effectively tying the "fence" of fund safety. Strengthen the coordination and linkage among departments, actively carry out joint law enforcement through mechanisms such as data sharing and monitoring analysis, case clue reporting, execution linkage, and synchronous reporting and supervision of major cases, and normalize the rectification of prominent issues in medical insurance fund management.

At the same time, the Medical Security Bureau of Yingshan County conducted inspections on all designated medical institutions, strengthened data analysis and screening, and achieved a comprehensive coverage and key supervision organic combination; Strengthen the cost review of medical insurance payment process, standardize and increase the frequency and frequency of daily inspections; Convene joint meetings, warning sessions, and talks on fund supervision, carry out special rectification of private hospitals, expose illegal and irregular cases, and create a regulatory environment that cannot be deceived.

It is reported that Yingshan has established a multidimensional regulatory model of "daily inspection+joint law enforcement+surprise inspection+big data analysis", conducting high-density and full coverage supervision and inspection of designated medical institutions in the county, and investigating a number of typical violations and illegal behaviors. From January to October 2025, one designated hospital medical insurance agreement and 29 designated retail pharmacy agreements will be terminated, 32 pharmacy agreements will be suspended, 77 medical institutions will be administratively punished, administrative fines of 502200 yuan will be imposed, 88 medical institutions will be dealt with through agreements, 11.8102 million yuan of medical insurance funds will be recovered (including refusal to pay), 366400 yuan of liquidated damages will be recovered, and 9 county market supervision bureaus will be handed over to severely crack down on illegal and irregular use of funds, maintaining a high-pressure situation of "dare not cheat".

Optimize services and write satisfaction into the hearts of the masses

Mr. Yuan, a resident of Hanlin Community in Laolin Town, Yingshan County, is nearly 80 years old and has been suffering from heart disease, hypertension, rhinitis, and a history of cerebral hemorrhage for a long time. He is a rural subsistence allowance recipient. On October 21st, he was admitted to Yingshan Hospital of West China Hospital of Sichuan University due to chronic obstructive pulmonary disease accompanied by acute lower respiratory tract infection. On November 4th, Mr. Yuan recovered and was discharged from the hospital.

In the past, it used to take several trips upstairs and downstairs to get discharged. Now the hospital implements' bedside settlement ', and we can handle it at the nurse station. The reimbursement funds will be promptly transferred to the bank card provided by the patient, which is time-saving, worry free, and very convenient! "Grandpa Yuan sighed.

Jiang from Lanwan Village, Damao Township, Yingshan County underwent organ transplantation surgery in March 2018 due to kidney failure. As of the end of 2024, there were a total of 14 hospitalizations and 20 outpatient treatments for chronic diseases, resulting in medical expenses of 382000 yuan and medical insurance reimbursement of 161000 yuan. The patient highly appreciates the high-quality service and efficient handling of medical insurance at Yingshan County Medical Insurance Center over the years, and specially gifted a banner with the words "Medical care for the people, spring breeze and rain relieve ten thousand troubles; policies safeguard health, warm sunshine shines brightly, and great love is written" to express infinite gratitude.

In recent years, the Medical Security Bureau of Yingshan County has actively promoted the integrated service of "one window acceptance", established a comprehensive teller system for window services, broken the traditional model of setting up windows for different departments, integrated 33 businesses such as insurance registration, expense reimbursement, and remote medical registration, and achieved "one person acceptance, one window processing", greatly reducing the waiting time for the public. Actively promote the "mobile application" and "online application" of medical insurance business, with a 100% online application rate for insurance payment, remote filing, and other related matters. Promote the sinking of medical insurance services to township (street) convenience service centers and village level medical insurance service stations, and achieve the "doorstep" handling of high-frequency medical insurance matters. Build medical insurance stations in enterprises to provide "nanny style" services for employees. Actively promoting the reform of "reducing materials, reducing links, and reducing time limits" handling services, greatly improving service efficiency, and enabling the masses to handle things smoothly.

Focus on digital empowerment and make efforts to achieve results in the intelligence of handling services. The Medical Security Bureau of Yingshan County has developed a county-level medical insurance collection and management system, utilizing the provincial medical insurance information platform to break down departmental data barriers and achieve real-time sharing of insured information, medical expenses, assistance qualifications, and other data. The introduction of an intelligent customer service system for medical insurance has greatly improved the ability to handle policy consultation issues. Promote the implementation of "contactless reimbursement", implement medical insurance reimbursement without application, and provide one-stop settlement for hospitalization expenses. Promote the full process application of medical insurance codes, integrate facial recognition function in the medical treatment process, and achieve the goal of "medical treatment without card, facial recognition without running away" for insured people, continuously improving their medical experience.

We will aim to build a medical service guarantee system that covers all areas, integrates urban and rural areas, connects in an orderly manner, is efficient and convenient, and provides warm services. We will continue to optimize the public services of medical insurance, improve the efficiency of handling and management, expand the depth of medical insurance services, highlight the warmth of medical insurance services, and improve the speed of medical insurance services. We will write a new chapter in Yingshan medical insurance for the people, benefiting the people, and facilitating the people! ”Liang Huimin, Director of Yingshan County Medical Security Bureau, said. (Peng Jie, Yang Hanguo)