Online is a serious illness for yinchuan Internet hospital outpatient service a serious illness into health care
On September 20th September 18 news, recently, the official launch of yinchuan 'hospital outpatient service a serious illness Internet yinchuan medical insurance management service (
Hereinafter referred to as & quot;
In this way)
Medical institutions, the original only in entity (
Make a diagnosis and give treatment way of hospital outpatient service a serious illness extension to hospital (Internet
, mainly to solve the problems in the patients with convenient go to a doctor, at the same time by yinchuan first try for demonstration district and even the whole country.
It is understood that these measures shall come into force on October 1, 2019, one year trial period, yinchuan hospital outpatient service a serious illness insurance pay to entry on the Internet age.
Than the big health conditions on the way to the comb from seven aspects: a, applicable diseases: first trial from high blood pressure, diabetes, build system of outpatient service a serious illness online medical bills to pay.
Second, the service object: to score the our city high blood pressure, diabetes treatment of outpatient service a serious illness ginseng protect personnel qualification.
Three, these procedures: ginseng protect personnel to choose Internet as the hospital outpatient service a serious illness signed online Internet hospital seeing a doctor.
At the same time, the hospital should set up the Internet ginseng protect personnel to sign up for the first time, change is signed, the information such as identity authentication, before signing on the same day 24 when will transmit the information to orgnaization of agency of insurance.
Ginseng protect personnel from the date of signing, enjoy online outpatient service a serious illness treatment in accordance with the relevant provisions;
Every June 30 June 1 solstice, on December 1 solstice December 30, can choose the Internet to the hospital and sign up.
Four, reimbursement methods: online outpatient service a serious illness diseases-related management of highest pay limitation, and offline entity bound to use, medical institutions in accordance with the unified autonomous region released annual outpatient service a serious illness disease to the highest limit standards.
Ginseng protect personnel to achieve multiple outpatient service a serious illness treatment status, online outpatient service a serious illness and highest pay limitation reduced order annual cumulative cap according to the regulations of the autonomous region;
Online limitation of outpatient service a serious illness is reduced after the disease of the highest pay limitation.
In addition, the funds required for the online outpatient service a serious illness funds from the worker in the row residents health care and medical insurance fund.
Five: reimbursement ratio, town worker outpatient service a serious illness fu biao above, conforms to the basic medical insurance policy within the scope of the medical costs, reimbursement ratio is 75%.
Enjoy allowance of officeholder medical treatment personnel, in accordance with the relevant provisions of the civil servants medical subsidy of yinchuan;
Urban and rural residents health care as one, two, three file capture expends, fu biao above conforms to the basic medical insurance policy within the scope of medical costs, reimbursement ratio of 50%, 60% and 65% respectively.
However, ginseng protect personnel to hospitalization, stop to enjoy the Internet hospital outpatient service a serious illness treatment.
Six, Internet hospital: Internet hospital outpatient service a serious illness and scope of diagnosis and treatment projects, in accordance with the relevant provisions of the autonomous region outpatient service a serious illness.
In addition, the hospital should establish medical insurance three Internet directory (
Project directory directory of medical insurance drugs, diagnosis and treatment and medical service equipment standard directory)
Library, drug prices shall not be higher than autonomous region three uniform price, diagnosis and treatment projects and disposable medical consumables prices should strictly implement the relevant provisions of the yinchuan and autonomous regions.
Seven, ways to settle accounts of expense of outpatient service medical treatment of a serious illness: instant settlement, ginseng protect personnel to pay only I should go to a doctor online out-of-pocket expenses;
By as a whole fund pays medical costs, hospital regularly settlement by orgnaization of agency of health and Internet;
When clearing, settlement and payment by 90%, first rest, after waiting for year-end appraisal, settlement and payment according to the assessment results.
Worker health, residents' health insurance settlement, respectively.
Actually, yinchuan Internet hospital medical insurance payment as early as 2017 has already begun.
In those days on March 19, yinchuan has released the yinchuan Internet hospital medical insurance personal accounts and management measures of the outpatient service as a whole
Hereinafter referred to as the 'method')
According to the 'method' regulation, ginseng protect personnel not only can use the cost of medical insurance personal account pay directly online to see a doctor, at the same time, all conform to the scope of three of the basic medical insurance directory of online fees, insurance reimbursement.
At the time of yinchuan this move is a nationwide is precedent.
However, in 2017, 'method', the outpatient service a serious illness has not been included, solution or basic health care.
Insurance of primary medical treatment is the important component of the social security system, is set by the government, unit of choose and employ persons and worker attend jointly a kind of social insurance, with low starting line, the characteristics of low reimbursement ratio.
Belong to the basic medical insurance and medical treatment of a serious illness as a whole system of the supplementary form, mainly deal with major disease risk, high starting line, and reimbursement ratio is quite high.
In recent years, Internet hospital after questioning, justify, eventually to support encouragement.
In 2015, the first Internet Internet wuzhen hospital formally established, controversial;
After three years, finally to its name, The General Office of the State Council issued 'about promote the healthy development of the Internet + medical opinions, allowed depends on the development of the Internet hospital medical institutions;
On 30 August this year, the national health insurance bureau also released on the Internet + medical service price and payment policy guidance ', on the Internet whether/how + medical services into the healthcare system, for the first time to make that clear.