Objectives:To explore the criteria of health insurance quality management in?clinical?departments of third-level grade A hospitals and provide references for the criteria. Methods:Self-designed questionnaires were used among staff of the government authorities, health insurance agencies, third-level grade A hospitals and health insurance associations. Datas were analyzed by SPSS17.0. Results: Among the 238 objects, 90.34% objects thought there was no or almost no unified criteria of health insurance quality management in?clinical?departments of third-level grade A hospitals, 70.01% objects thought it was urgent to make a unified criteria. “Appropriate treatment” and “Incorruptible and self-discipline” were considered as the most important criteri．Conclusion: It is urgent to make a unified criteria of health insurance quality management in?clinical?departments of third-level grade A hospitals.