In response to China's national "Healthy China" initiative and the deepening reform of its medical security system, empowered by medical insurance data from the National Healthcare Security Administration, undertaken by Beijing's Xicheng District, and operated by Beijing Jishubao Health Technology Co., Ltd., a state-owned enterprise under Xicheng District, successfully implemented a groundbreaking Medical Insurance and Commercial Health Insurance Clearing and Settlement Platform. This innovative endeavor has created significant ripples in the medical security landscape, with numerous insurance institutions actively integrating into the platform, collectively ushering in a new chapter of "Medical Insurance and Commercial Health Insurance" integrated development. Among these pioneers, Ping An Group's flagship healthcare arm, Ping An Good Doctor, alongside Ping An Technology, Ping An Property & Casualty Insurance, Ping An Health Insurance, and Ping An Annuity, has deeply participated in the pilot program and have developed "Ping An Yi Jian Fu", launching the nation's first product that leverages medical insurance data to achieve "seamless claims" through the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center. This initiative injects new vitality into the optimization and upgrading of China's medical security system.
This innovative move aligns perfectly with the national macro-strategy of building a multi-tiered medical security system, which consistently promotes the complementary roles of commercial health insurance and basic medical insurance to enhance overall medical security efficiency. The platform built by the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center acts as a robust bridge, successfully breaking down data barriers between medical and commercial insurance. It achieves seamless integration in critical areas such as data interaction and expense settlement, ensuring that every medical and commercial insurance fund is precisely utilized. This powerfully drives the implementation of national medical security strategies, fortifying a robust health defense for the stable development of the national economy and society.
From a public welfare perspective, the successful pilot of this platform is undoubtedly a timely solution, effectively addressing the pain points faced by patients seeking medical care. In the past, the complex reimbursement processes for medical and commercial insurance often required patients and their families to shuttle between hospitals, medical insurance departments, and insurance companies, consuming significant time and energy and causing considerable stress. Now, Ping An Yi Jian Fu, leveraging its unique product advantages and the powerful capabilities of the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center, enables "one-code direct payment" and "seamless claims" during the medical treatment process. Patients no longer need to pre-pay expenses or navigate cumbersome post-treatment claims applications. With a single scan of the commercial insurance code, the system automatically completes the clearing and settlement of commercial insurance claims, truly making the claims process "zero-perceptible." This convenient and efficient model not only significantly improves claims efficiency but also provides patients with an unprecedented medical experience, allowing them to focus entirely on treatment and recovery. It greatly alleviates patients' financial and psychological burdens, truly benefiting the public and serving the people, significantly enhancing their sense of gain and well-being.
For insurance institutions, the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center brings comprehensive transformation and enhancement. Through data integration with the platform, insurance companies can provide a more scientific and precise basis for risk assessment and product pricing. The efficient settlement process acts as an "accelerator" for claims work, significantly shortening the claims cycle, reducing operational costs, and improving service quality and customer satisfaction. This series of positive changes further invigorates the commercial health insurance market and promotes the healthy and sustainable development of the insurance industry.
As an innovative pioneer in this pilot, Ping An Yi Jian Fu is deeply integrated into the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center. Its innovative commercial insurance direct payment function has been fully validated and applied in pilot scenarios, providing a replicable and scalable successful model for the integrated development of "Medical Insurance and Commercial Health Insurance."
Looking ahead, the Medical Insurance and Commercial Health Insurance Clearing and Settlement Center, insurance institutions, and other parties will continue to work together to continuously optimize the functions and services of the clearing and settlement platform and expand the application scope of the pilot results. They will continue to explore new models and pathways for the integrated development of "Medical Insurance and Commercial Health Insurance," allowing more people to enjoy more convenient, efficient, and high-quality medical security services, and contributing to the construction of a "Healthy China."
