It is one of the hot spots in recent years to provide immediate settlement services for a large number of remote medical groups. Based on the related concepts and the design of the national policy, this paper clarifies the connotation and types of remote medical treatment and remote medical treatment, analyzes the existing policy orientation, and puts forward the main problems of real-time settlement in different places. In the new stage of the reform of the medical and health system, combined with the relevant reform and practice, this paper puts forward the realization path of real-time settlement of medical treatment in different places