Cross -provincial medical direct settlement and outpatient reimbursement ... Zhengzhou issues "big prescriptions" for benefiting people's medical insurance services

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Medical security, the health and peace of thousands of households. How can we really reduce the burden on the masses to see a doctor? How to make the insurers enjoy more convenient and considerate medical insurance services? ... Zhengzhou started with a "small incision" that is closely related to the interests of the people, and issued the "big prescription" of optimizing medical insurance services, benefiting the people, convenience, and the people.

Direct settlement of "medical treatment" across provinces

"It's really convenient to see a doctor now. Even if you see a doctor across the province, you don't need to toss them back and forth!" As a beneficiary of direct settlement for medical treatment in different places, Mr. Chen, who is retired in Zhengzhou, Sichuan, sincerely lamented.

Mr. Chen worked for insurance in Zhengzhou and moved to Guangyuan, Sichuan after retirement. In July this year, he was treated at the outpatient clinic of Cangxi County, Guangyuan City for malignant tumors. The medical expenses incurred by the outpatient clinic were settled directly in different places.

The situation of Zhang Girls from Yunnan is exactly the opposite. She was originally insured in Dali, and now she is in Zhengzhou. In the past, I needed to pay for the treatment of a doctor across the province before reimbursement. Now she is treated with uremia dialysis in the outpatient clinic of Zhengzhou Medical Insurance. It can achieve direct settlement in different places with social security cards.

A small social security card is a recorder and witness of the people enjoying the service of "Heart Heart Insurance".

In recent years, with the rapid development of the economy and society, the flow of population across regions has become increasingly frequent. In order to allow the insured to better enjoy the most intimate and convenient medical insurance services, Zhengzhou continues to expand the scope of medical settlement for medical treatment in different places.

In the first half of this year, Zhengzhou's "two -way" comprehensively opened 5 outpatient slow special disease treatment costs directly settled in provinces. 27 settlement medical institutions opened outpatient clinics and specially settled directly provinces, covering 16 districts and counties (cities) in the city. At the same time, 186 scheduled pharmaceutical institutions realized the direct settlement of outpatient expenses in different places; all categories, including retired cadres and military and rest cadres, were directly settled by the category of insured persons in different places. As of the end of June, the city had completed a total of 19,218 medical records in different places, settled 17,192 directly, and the medical insurance fund paid 67.7824 million yuan.

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"Outpatient Fair" brings medical treatment for medical treatment

In fact, in Zhengzhou, "medical insurance benefits the people" has never been a slogan, but a down -to -earth people's livelihood policy.

From July 1 this year, Zhengzhou has launched a full -scale guarantee system for the implementation of employee medical insurance clinics. This reform is one of the most important reforms since the establishment of a medical insurance system in our city. According to estimates, through the method of reforming personal accounts, the city is expected to release 1.91 billion yuan for outpatient reimbursement for the outpatient clinic of 2.94 million participants. The maximum reimbursement outpatient cost of each person is 2,300 yuan per year.

After the implementation of the New Deal, the city has established a "trinity" treatment guarantee system for employee medical insurance outpatient medical medical accounts, outpatient coordination and outpatient slow special diseases, effectively alleviating the problems of minor diseases, medical examination, and over -medical treatment before the reform. Further improve the efficiency of fund use.

"The medical expenses generated by the hospital's outpatient clinic could not be reimbursed. Now the minor illness and small pain can be reimbursed in proportional to the medical insurance in the outpatient clinic, which is indeed very affordable." On August 23, the patient Wang Girls Girls Girls in the Ophthalmology Clinic of the Second People's Hospital of Zhengzhou City. Holding your own settlement form: "There are more than 600 inspection fees and medication expenses today, and medical insurance reimbursement has been reimbursed nearly half!"

Not only Ms. Wang also felt the same. Data show that in the first month of the implementation of the New Deal, the city's employee medical insurance clinics coordinated 545,600 medical treatment, the total cost of medical insurance payment was 63.51 million yuan, and the average reimbursement ratio of compliance costs was 59%, which effectively reduced the burden of medical expenses for the outpatient medical expenses of the masses, especially the elderly, Essence

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Create a "15 -minute service circle" for medical insurance for the people

There are thousands of households in medical security. For many years, Zhengzhou has always put medical insurance "benefiting the people, convenient, and being the people".

Based on this, Zhengzhou Medical Insurance continues to simplify procedures, optimizes processes, cancels the medical examination, and realizes the "full -scale online operation" of slow special disease management. Can be declared online. In the first half of the year, a total of 3,7757 people were applied for slow special diseases and 26,179 people were approved. In the current period, a total of 989,600 people enjoy the treatment of slow special diseases for outpatient clinics.

In order to help the "rural rejuvenation" strategy, Zhengzhou improves medical insurance and rescue systems, uniform medical assistance systems, and strengthen the comprehensive protection of basic medical insurance, major illness insurance, and medical assistance. Extraordinary diseases affect basic life. From January to June of this year, a total of 55,800 people in the difficult people had been handled, and the funding was 17.8438 million yuan; the medical insurance benefits of the difficult people had 29,963 people and 17.807 million yuan, which effectively curbed the phenomenon of returning to poverty due to illness and illness.

In order to continue to optimize innovative medical insurance services, Zhengzhou sank 23 medical insurance high -frequency service business to streets, communities, hospitals, banks, etc. to optimize and improve the 156 "Zhengzhou Medical Security Service Station", and start construction stations new construction sites.90, create a "15 -minute service circle" for medical insurance.At the same time, with the help of informatization, Zhengzhou realizes 37 public business and 40 personal business online and hand -in -hand. It is the first to carry out mobile payment pilots in the province to achieve registration of medical insurance electronic vouchers, diagnosis and treatment, medicine collection, settlement, query, etc.The online and offline full -process application, open the last "one kilometer" of medical treatment and medical insurance settlement.Zhengguan News · Zhengzhou Evening News reporter Wang Hong

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