Under the background of "Internet + medical health"，the electronization of medical bills has gradually become one of the keys of medical reform，but the existing medical electronic bills still have difficulties in distinguishing the authenticity of bills，lack of credible circulation mechanism，repeated reimbursement and high risk of insurance fraud. Based on the analysis of the coupling between blockchain and medical electronic bill management in the main objectives，system construction and regulatory requirements，it constructs the system framework and operation process of the block chain medical electronic bill circulation mode. It further put forward three aspects of technology，standard and application to promote the blockchain technology enabling the scale development of medical electronic notes.