Pay close attention to the construction of the management system to optimize the quality of medical insurance services

Xi'an Economic Office Service System Construction Achievement Exhibition

——We Yang District Article

The medical insurance work of Weiyang District has always adhered to demand -oriented and problem -oriented, focusing on the urgency of the masses in the medical insurance office service processing, and the annual key tasks of the year. Maintain the personal interests of the people into the starting point and end point of all work, combine "I do practical things for the masses", strengthen service concepts, optimize the level of running, innovate service forms, solidly promote the construction of the service system for medical insurance office, and comprehensively connect medical insurance and medical insurance and medical insurance The bond of the masses provides a convenient service to the home -style convenience service to effectively open up the "last meter" of medical insurance services.

1. Consolid the base point-building mechanism, set up a group, give full play to the mechanism to lead

In order to ensure the smooth progress of the construction of the four -level service system of Weiyang District Medical Insurance, the Weiyang District Medical Insurance Bureau specially studied and deployed the construction of the medical insurance system in accordance with the spirit of the relevant documents of the national provincial and municipalities, combined with the experience of Xunyi, and inspected the Municipal Bureau and Brothers many times on the spot. The construction of the district and county, combined with the actual situation of the district, issued the "Implementation Plan for Optimizing the Service System of the Fourth -Level Medical Insurance Economic Insurance System for the Construction of the Fourth -Level Medical Insurance Economic Insurance System" in the name of the region, and promote the construction of the medical insurance system with high standards. The schemes have clearly stipulated the software and hardware equipment of the medical security service station (room, point). At the same time, in order to ensure the smooth development of the service system construction work, the District Medical Insurance Bureau held a special meeting many times. Improve the work system, carefully organize planning, clarify the work goals and division of responsibilities, effectively improve political standing, and consolidate work responsibilities.

2. Focus on the key points-strong supervisor, implementation, and force the system to launch

(1) Clarify the system structure and innovate the extension service chain. Based on the reality of Weiyang District, the innovative service chain is established to build the "district-street-community (village)-community" four-level medical insurance service system. The district medical insurance office as the center and the street medical insurance service station as the hub, community (village) medical insurance service room as the front end, community work service station, and medical insurance service point to the end. To the end, build a flat, efficient, and intelligent fourth -level medical insurance service system.

(2) Strengthen the construction of bidding and promote the "14551" demonstration creation. According to the national medical security service window construction standards, the Weiyang District Medical Insurance Economic Affairs Office, in accordance with the requirements of the "four most" and "six unifications" requirements, streamline the materials, simplify the processing process, shorten the time limit for handling, and strive to create a medical security service for the masses. Continuously strengthen business training for medical insurance management and window personnel, and business training such as medical insurance policies, processing processes, and service standards, and achieve initiative, enthusiasm, patience, thoughtful, and comprehensive. There are 9 offices in the hall of Weiyang District Medical Insurance Economic Affairs Office. The service facilities are perfect. There are intimate services such as guiding consulting area, self -service area, automatic call area, waiting for rest area, and red book corner. "Medical Insurance Life Guard" service slogan. Comprehensively implement the list of government service services for medical security, and the annual processing business is 80,000.

全区10个街道和241个社区（村）、480个小区分别依托基层党群服务中心和小区工作站，设立了医疗保障服务站、室、点，统一医保服务标识，固定服务窗口，制度牌、 The standardized construction of work responsibilities and lists has fully realized landmark identification functions. At the same time, 251 medical insurance (part -time) personnel (part -time) personnel are equipped to ensure that there are at least 1 college (and) employees in each street and community.

(3) Comprehensive monitoring and supervision, and consolidating the implementation of responsibilities. Weiyang District Medical Insurance Economic Affairs Office monitors and summarizes the construction of the region's economic offices daily, and regularly reports. The evaluation of the demonstration site of the medical security grassroots service demonstration sites conducted on -site evaluation, and took multiple measures to vigorously urge the construction of the service system to be carried out efficiently and orderly.

(4) Optimize the allocation of resources and strengthen the sinking function. Weiyang District Medical Insurance Economic Affairs Office is actively coordinated to provide sufficient manpower, equipment and other resources for the service stations (rooms) of grassroots medical insurance. (Village) medical insurance specialized business training and policy explanations, vigorously improve the service level and efficiency of grassroots management, ensure that grass -roots medical insurance service stations (room points) can develop long -term development, and establish a long -term development mechanism for the four -level medical insurance service service. Clarify the street office, community (village) medical security service station (room point) to carry out basic medical insurance participation and change registration, basic medical insurance participation information inquiry and personal account withdrawal, basic medical insurance participants for medical treatment , Basic Medical Insurance Insurance Insurance Council for Medical Costs (sporadic) Reimbursement data for reimbursement data, medical assistance object data collection and preliminary examination, etc.

(5) Comprehensively open the special network and strengthen information guarantee. In order to fully open up the connection of the medical insurance network of Weiyang District and improve the efficiency and quality of the office, Weiyang District via telecommunications operator, relying on the Electronic Government Unicom Weiyang District Medical Insurance Office, the street office, and communities to comprehensively open up the district's medical insurance network, each of which The street office can be connected through the electronic government foreign network, and the community (village) can be used normally through VPN login.

(6) Implement the guarantee of funding to ensure that "money is done." According to the "Notice of the Opinions of the Xi'an District Party Committee Office of the Xi'an District Party Committee of the Xi'an District Committee of the Communist Party of China on the Office of the People's Government of Xi'an City, the Office of the Establishment of a Community Workstation Selected Hiring Building Foundation Consolidate the Grassroots Foundation" (Unpaid [2022] No. 1), extend the tentacles of the work, The equipment is the "data officer", "information officer", "propagandist", "waiter", "mediation officer", "supervisor", and "security officer" of the residents of the residents of the community. Incorporate work funds into the fiscal budget, and subsidize the work subsidy of the community building in accordance with 200 yuan per person per month, shall be responsible for assessment and distribution. (7) Open the "Director Reception Day", open the channels for faith, and open up. In order to continue to optimize the business environment, deepen the reform of "decentralization of service", take the people as the center, effectively serve the masses, and safeguard the interests of the masses. The leaders of the bureau received the people in the medical insurance window of the Government Service Hall of Weiyang District, patiently answered the questions of the masses, listened to the voice of the people, and understood the suffering of the masses. Through direct exchanges with the director with the front desk, they fully understand the opinions and suggestions of the masses on the current medical insurance office work, and provide support for the people of innovation medical insurance.

Third, highlight highlights-excellent services, advanced trees, consolidate the effectiveness of construction

(1) Promote the "bank+medical insurance" service to promote the convenience and popularization of medical insurance services. In order to further enhance the medical security service capabilities and provide convenient and efficient medical security services for the people participating people, to the greatest extent allows the masses to "run the road, run short circuit, and do it nearby". The medical insurance business enters the bank outlet event, set up a separate medical insurance special window in the banking hall to complete the standardized construction of medical insurance service window logo, medical insurance service window suspension, posting "China Medical Guarantee", "Medical Security Convenience Service Point" and other standardized construction. Equipped with office equipment required for work. Insured participants in different places for medical treatment, unit participation registration, individual insurance registration registration, unit participation information change registration, employee participation information change registration, insured unit inquiry, print medical insurance information and other high -frequency businesses to create Weiyang to create Weiyang Medical Insurance "Bank+Medical Insurance" characteristic brand.

(2) Promote the "Internet+Medical Insurance" service and promote digitalization and intelligence in medical insurance services. Combined with the actual business situation, using the Internet emerging media such as WeChat, QQ, and public accounts, China Unicom Street Office, community (village) to further expand the network coverage of the medical insurance business, improve the information level of online -run information, and promote more medical insurance services. , "Palm on the hand", "not meeting", "in time", and introduce a small video of medical insurance for one minute, allowing the masses to understand and grasp the relevant policies more intuitively, and promote "only one door and run once". Let the participating people enjoy fast and convenient medical insurance services. Since the launch of the new medical insurance system, the number of visitors and business consulting of the "We Central Medical Insurance" public account has exceeded 468,000.

(3) Hold the construction and observation meeting of the organizational system, and give play to demonstration to lead the effectiveness. In order to timely consolidate the effectiveness of the service system of the medical insurance agency of Weiyang District, play the role of the radiation driving point of advanced demonstration sites, and at the same time improve the professional literacy and professional skills of the running teams, Weiyang District holds the service system construction observation meeting and medical insurance policy training meeting. The construction demonstration site of the management system introduces construction experience and achievements to everyone, and at the same time carry out business policy training, guide the advanced standards of streets and communities (villages), find the gap, and promote the further improvement of the operation system.

Editor in charge: Liu Shuhai

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