On January 15, and one, the village clinic medical insurance card can be brushed, and reimbursement ratio as high as 80%.
Released recently, the tianjin WeiJianWei on the support of county-rural health service integration management is considered to village clinic outpatient medical expenses reimbursement notice (
Hereinafter referred to as the 'notice')
'Notice' is put forward, in line with the conditions of village clinics may apply for the conduct of outpatient service medical treatment fee into the reimbursement.
Village clinics must meet WuTongYi eligible for tianjin standardized construction of village clinics, and institutes of health (
Township hospitals, community health service center, hereinafter the same)
WuTongYi county-rural health service integration management, can apply for outpatient medical expenses included in the reimbursement.
(1) unified management (2) business management (3) the financial revenue and expenditure management (4) unified medicines and medical equipment procurement management (5) performance appraisal and compensation allocation management, reimbursement ratio as high as 80% of ginseng protect personnel to happen in the village clinic outpatient service seeing a doctor medical costs, in accordance with the relevant level of the medical establishment that decide a dot the outpatient reimbursement policy.
Among them, the village clinics charge a general fee by the regulation, highest pay limitation the following medical treatment charge in outpatient service, by fund of insurance of primary medical treatment expenses 80%, 20% individual responsibility.
Sign signing the family doctor service ginseng protect personnel, in accordance with the relevant provisions of the city, can enjoy treatment of relevant health care at the same time.
Village clinics into insurance reimbursement?
From the point of 'notice', conform to the conditions of the village clinic application outpatient medical expenses into the reimbursement work, need to complete the following steps.
Apply: in the name of the institutes to the district health health committee put forward written application;
Superior verify: the village clinics, village doctor configuration and verify WuTongYi county-rural health service integration management relevant situation, in conformity with the relevant provisions of the agency to apply for the transfer area medical insurance bureau;
Connected with city health monitoring systems: village clinics should install Internet + intelligent supervision equipment such as video surveillance, and connected with the city health monitoring system;
Negotiations, signed an agreement: and village clinics affiliated institutes of negotiations, determine the fitting into the outpatient reimbursement list of village clinics.
Submitted to the municipal health care center for the record, the area of health information and its jurisdiction village clinics affiliated hospital medical insurance fixed-point service agreement.
Note: information village clinics and rural doctors information unified the institutes to jurisdiction in accordance with the relevant provisions of the municipal health care information to declare, and incorporated into the medical treatment guarantee system of information management.
Information change should deal with relevant changes hands.
Violators will be included in health care blacklist 'notice' is put forward, to village clinic practice total management, protocol management and supervision and management of the three aspects of regulation.
One is, the village clinic outpatient medical expenses include affiliated institutes pay total accounting index management of medical insurance.
Department of hospital outpatient amount index on the basis of accounting in accordance with the unified the city plan, additional give no more than 20% of the growth.
The second is to strengthen the village clinics and township medical practitioners daily management, found in violation of the service agreement, protocol processing in a timely manner.
Three is that clearing fees, and so on and so forth into the village clinic outpatient service networking intelligent audit system and real-time monitoring system of management of medical insurance.
Serious punishment of violation behavior, and notify related departments in accordance with the relevant provisions, if the circumstances are serious under the joint discipline, health-care blacklist for transfer of suspected criminal judicial organs shall be investigated for criminal responsibility according to law.
At present, many parts of the country have carried out the pilot work for the village clinic into the medical insurance fixed-point.
Take tianjin as an example, big ZhangZhuang Town and west dike head as early as 2017, 18 village clinics in the domain has been carried out health care networks and settlement.
Unlike before, the tianjin will be expanded to the village clinics in the city, you can feel its a step closer, in terms of strong base (see article) sets a good example for other provinces and cities.
Improving the capacity of rural grassroots medical and health services, the medical security is an indispensable part of.
Only grassroots medical institutions all aspects are perfect, to better serve the masses of the people to provide basic medical and health services.