The clinic of community of Qingdao can also submit an expense account to see the doctor Can wipe out half within the 1500

The clinic of community of Qingdao can also submit an expense account to see the doctor Can wipe out half within the 1500
The clinic of community of Qingdao can also submit an expense account to see the doctor Can wipe out half within the 1500
The news of morning newspaper effected an insurance personnel can enjoy the ordinary clinic to see the doctor too to submit an expense account! Yesterday, unite the Bureau of Finance according to municipal Labour Insurance Bureau, what the health bureau jointly issued stipulates " about choosing some fixed community medical organizations to launch the notice that the clinic conducts the pilot project in the district of city four ", in include pilot 4 districts of range in this time ' The south of the city, the north of market, square, Lee's deep blue) Retired ex-employee on the job, within the limit of a year for medical treatment, each person sees the doctor to the designated clinic of community's hospital, the hospitalization cost of the cost does not only exceed 1500 yuan ' Includes 1500 yuan) ,Can submit an expense account according to 50%, namely only need 750 yuan at one's own expense. This new regulation is carried out from January 1 next year, the pilot project can be popularized to three other districts after succeeding. Spend money paying by credit card and submit an expense account the relevant person in charge of municipal Labour Insurance Bureau introduces, select the hospitals of 8 communities in the district of city four altogether at present, as the pilot unit (see the list) of clinic pool of the basic medical insurance ,A retired ex-employee on the job can choose a family wantonly nearby to effect an insurance. From January 1 next year, personnel get to effect an insurance in condition that accord with when the community hospital selected by oneself sees the clinic, no matter pay the cash and use the medical insurance card, so long as does not exceed 1500 yuan within an annual medical treatment year, can submit an expense account according to 50% of the proportions. So long as does not overspend, effect an insurance personnel only need to pay half expenses by oneself while seeing clinic, the remaining half are settled with medical insurance centre by community's hospital. In addition urban residents the intersection of medical insurance and clinic wipe out proportion, still until original 30% of regulation wipe out proportion, carry out, upper limit is 1200 yuan in an annual medical treatment year. Effect an insurance the intersection of personnel and pool monthly according to regulation, effect an insurance on the job and retired ex-employee, must participate in the intersection of clinic and pool. It conducts proportions to be: Retired personnel raise the pool money of clinic according to the standard of 30 yuan for each person every month, among them individual pays 10 yuan, is handled the organization to withhold from their personal accounts by the social insurance, draw in another fund from the medical insurance according to 20 yuan for each person every month; The on-the-job personnel raises according to the standard of 18 yuan for each person every month, among them individual pays 8 yuan, handle social insurance organization, withhold in personal account their, in the intersection of pool and fund until 10 yuan drawn for each person every month another. Contract selected family doctor accord with to effect an insurance personnel terms, can choose one the intersection of medical insurance and the intersection of community and fixed unit voluntarily, as one's own fixed medical organization of ordinary clinic, and choose an eligible doctor as one's own " family doctor " ,Sign the relevant service agreement. Worker and retired personnel of effecting an insurance as to already signing family doctor's service agreement with fixed community originally, like, participate in clinic this conduct pilot project, should reach pilot the intersection of community and medical organization contract or get the ticket endorsed after the normal time pilot agreement again. For help, join sponsor, choose, municipal Labour Insurance Bureau require fixed the intersection of community and medical organization, should in the announcement of the influential position the intersection of our unit and eligible the intersection of family doctor and list. The fixed unit of medical insurance community that the representatives of family doctors contracted, must serve for joining sponsors and offering the following: Implement the health survey, set up health file; Launch the health education and prevention and health care; Offer a foundation to check the body healthily every year; Provide the intervention of living environment, life style, healing solution for chronic disease patients such as diabetes, hypertension,etc., and follow, follow up a case by regular visits to; Offer the ordinary outpatient service, pay a home visit, make a round of visits and change the place of examination and serve bidirectionally; Handle relevant business such as serious disease of clinic, hospital bed set up at a patient's home, old community's medical attendance. Serious to change the place of examination immediately In order to realize " It is small the disease is in the hospital at the community, serious disease, recover back to the community " Goal,implementation be examined and changed the place of examination by systemmed bidirectionally community head. Demand, contract, join after the ill sponsor, should the intersection of medical insurance and the intersection of community and fixed unit in I go to a doctor at first, because the condition needs changing the place of examination, should be verified and signed from the signing family doctor, go through the registration of changing the place of examination formalities. Contract effect an insurance worker change the place of examination by fixed the intersection of community and medical organization take place in hospital expense, do not enjoy community's medical preferential treatment. Because emergency call, rescue direct hospital treatment, should in in hospital, get one's own medical insurance make up the procedure of changing the place of examination by fixed unit by community in the 7 day. Patient's condition accords with one of the following conditions, the fixed unit of medical insurance community should keep the fixed unit of the institute and go through formalities of changing the place of examination to higher authorities' medicine for the patient in time: The urgent critical disease of every clinical subject, the unit organization is difficult to treat and cure effectively by fixed position in the medical insurance community; Difficult disease can't be made a definite diagnosis of; In the great casualty accident, it is limited to handle ability; Registration subject of making a diagnosis and giving treatment and going beyond this organization to check and approve to make a diagnosis of disease; Need, get at a higher level medical organization make, check further, define, diagnose; The others exercise restraint in not can't be handled because of the technology, apparatus condition. In addition, patient's condition accords with one of the following conditions, medicine should change the place of examination to the fixed unit of medical insurance community in time while keeping the fixed unit of the institute: The condition is steady after acute treatments, need to continue rehabilitation; It is clear to diagnose, does not need special treatment; The treatment, approaching one's end care that various malignant tumour patients do not perform the operation in later period; It needs the therapeutic for a long time one to suffer from chronic disease; Need to accept old medical attendance; Psychological obstacle spiritual convalescence such as disease, can unit organization accepts treatment for revovering by fixed position in the intersection of medical insurance and community; General common disease, frequently-occurring disease. Family doctor's qualification family doctor should possess the following conditions: Have professional title of the above-mentioned intermediate, obtain medical practitioner's qualification, and the practising place is in this organization; Internal medicine department, department of traditional Chinese medicine speciality or by qualified that the complete doctor is trained; Age, within 65 years old in principle, healthy, can adhere to the fulltime work. The fixed unit of medical insurance community should allocate no less than 1 family doctor's assistant, 1 to 2 nurses for the family doctor. In addition, in order to guarantee the service quality, the ones that stipulate each family doctor can't exceed 2000 to serve the number of people contracting, among them retired ex-employee and old resident, severe disabled person can't exceed 500 people. Can enjoy many kinds of preferential policies to contract in order to encourage effecting an insurance to join sponsors in the community the patient to the fixed community of the medical insurance to go to a doctor, offer, submit an expense account while being appropriate to ordinary the intersection of clinic and medical fee its, enjoy health, consult body, health control wait for and meet, and enjoy the corresponding preferential policy in submitting an expense account standardly. The main regulation is as follows: Contract, effect an insurance worker and retired personnel change the place of examination hospital treatment through the intersection of medical insurance and the intersection of community and fixed unit, its pool arises one pair of standards is reduced by half and carried out, the medical fee of one pair of under 20000 yuan part above standards arises, the personal conceited proportion is reduced by two percentage points. Change the intersection of medical insurance and the intersection of community and contracting, joining sponsoring unit by fixed position over to, can launch follow-up treat through handling serious disease of clinic, hospital bed set up at a patient's home or old medical attendance, pool its get up pairs of standard 300, use class-B medicines enter the intersection of pool and conceited 10% pay, cancel the conceited proportion; Conceited the intersection of proportion and 20% and the above, reduce by 10 percentage points. Contract, join sponsor, suffer from, keep, cut department, presume by medicine annual the intersection of pool and money pay clinic serious disease number of limit at most ' Serious disease and hepatitis, liver are hard Except melting) ,Can choose fixed unit of medical insurance community as one's own medical organization. Contract, effect an insurance the intersection of worker and pool it pays the conceited proportion in the range to be 8% among them, exceed, pay limit, accord with pool, pay range part, wipe out 70% at most. Contract and join sponsors and apply to handle hospital bed set up at a patient's home and old medical attendance, the retired personnel of conceited proportion of the expenses of hospital bed set up at a patient's home are 4%, the on-the-job worker is 8%, other personnel are 30%. (Chen Ke)


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