The most important thing of medical insurance audit is to ensure the rationality and compliance of medical insurance expenses, so as to ensure the safe and effective use of medical insurance funds. Specifically, the medical insurance audit needs to supervise and inspect the medical service behaviors of medical institutions and individuals, including the review and evaluation of medical expenses, hospitalization days, medication expenses, rationality of diagnosis and treatment, and find unreasonable medical behaviors, medical insurance fraud and illegal use of medical insurance funds, and take timely measures to correct them. At the same time, medical insurance audit needs to strengthen the training and guidance for medical institutions and doctors, improve their awareness of medical insurance and compliance, so as to make the use of medical insurance funds more standardized, transparent, fair and effective.

Medical insurance refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection.