XXX基本医疗保险管理制度.pdf

XXX基本医疗保险管理制度--第1页

XXX基本医疗保险管理制度

TownHealthCenterBasicMedicalInsuranceManagement

System

1.BasicMedicalInsuranceDoctorManagementSystem

1)Doctorsatalllevelsshouldstrictlyimplementthefirst

diagnosisresponsibilitysystemandtheprincipleoftreatment

basedonillnessformedicalinsurancepatients。Theyshould

conductreasonablens。treatments。andn。strictlyprohibitover-

prescribing。repeatedprescribing。andover-dischargingwithn。

2)Strictlygraspthenstandards。verifythepatientsidentity

withthemedicalinsuranceICcardorIDcard。andpreventXXX。

KeepacopyofthemedicalinsuranceICcardorIDcardinthe

medicalrecordforXXX。XXXbearthecost.

3)Clinicaldiagnosisandtreatmentshouldfollowthe

principleofconductinggeneralnandtreatmentfirst。andthen

XXXtoandusetheresultsofXXX.

XXX基本医疗保险管理制度--第1页

XXX基本医疗保险管理制度--第2页

4)XXX。Formedicalservicesthatarenotcoveredoronly

partiallycoveredbytheinsurance。suchasClassBcatalogdrugs。

self-paiddrugs。andsingle-itemnsthatcostmorethan100yuan

(including100yuan)。orsingle-itemphysicaltherapythatcosts

morethan200yuan(including200yuan)。theconsentofthe

beforeXXX。theinsuredhastherighttorefusetopaytherelated

self-paidexpenses。Inthecaseofemergencytreatmentwherethe

patientisunabletosignandtheirfamilymembersarenotpresent。

thedoctorshouldXXX.

5)StrengthenthemanagementoftheuseofXXX(costing

morethan1,000yuan)。approvalmustbeobtainedfromthe

medicalinsurancedepartment。andXXXthemedicalinsurances

limitpriceaccesssystemforXXX。tests。XXXhospitals。the