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Introduction of Medical Insurance Department
1.The medical insurance Office works under the leadership of the hospital leaders and the hospital medical insurance management team, is responsible for the daily affairs of the hospital medical insurance work, effectively protects the interests of both doctors and patients, and ensures the standardized and smooth implementation of the medical insurance system。
2.Scope of daily management of medical insurance Office: outpatient management, inpatient management, hospital transfer management, medical malpractice management, drug management, approval of special examination (drug use), approval of over-quota unconventional patients, financial accounting, calculation management, and other matters related to medical insurance work (such as publicity and interpretation of medical insurance policies)。
3.Effectively strengthen the medical management of medical and agricultural insurance patients, standardize the implementation of medical and agricultural insurance policies, for medical and agricultural insurance patients to avoid inspection people, cards, cards, in line, can be used to dispense drugs or hospitalization, if there is no compliance with the medical insurance IC card, and inform the municipal medical insurance office。
4.Strictly implement the responsibility system for the first diagnosis of medical insurance patients, adhere to the treatment of illness, achieve reasonable examination and reasonable treatment, put an end to human remedies and large prescriptions, resolutely put an end to the exchange of medical insurance drugs, and strictly grasp the indications of hospitalization and transfer of medical insurance patients。
5.Regular inspections and regular spot checks should be combined to deal with violations of discipline in medical insurance services in a timely manner, and medical and agricultural insurance services should be included in the annual assessment of departments or individuals, and the best and the worst should be rewarded。And according to the impact of the violation of the matter, the implementation of a veto。
6.We will strengthen publicity for medical, agricultural and insurance policies,Actively create a good atmosphere for medical insurance,Set up "serious illness medical insurance policy publicity column" and serious illness medical insurance complaint box "to publish the information trend of medical insurance policy in a timely manner,Strengthen and standardize the understanding and implementation of medical insurance West policy and "three directories" knowledge by medical staff,Pay attention to both social and economic benefits,Make medical and agricultural insurance patients satisfied in our hospital。
7.Strengthen the consultation and communication with the municipal medical insurance office, timely convey the relevant documents and information dynamics of the municipal medical insurance office, collect and report the ideas and doubts of medical and agricultural insurance patients, so as to satisfy the government, the masses and the hospital。