Three-A hospitals: Inner Mongolia Hospital, the First Affiliated Hospital of Inner Mongolia Medical College, Inner Mongolia Zhongmeng Hospital
The Second 53rd Hospital of the People's Liberation Army?
Triple B Hospital: Hohhot First Hospital Hohhot Railway Bureau Central Hospital Armed Police Force General Hospital?
Other hospitals: the new city hospital Yuquan District Hospital Suburban Hospital Inner Mongolia Civil Aviation Hospital
Neimenggu Prison Administration First Hospital Inner Mongolia Hohhot Prison Hospital
Neimenggu Hohhot Prison Hospital Hohhot Second Hospital Heshi Company Employees Hospital
Neimenggu University Hospital Inner Mongolia University of Technology Hospital Inner Mongolia Agricultural University Hospital
Neimenggu Geological Survey Bureau Outpatient Department? Designated pharmacies:?
Zhongshan Pharmacy Yonglingtang Pharmacy Li'an Pharmacy Railway Pharmacy Tongren Pharmacy Kaimeng Pharmacy Railway Hospital Pharmaceutical Department Huayu Pharmacy Zhonglian Pharmacy General Store Xiaozhao Pharmacy
Aimin Pharmacy New Specialty Drugs Pharmacy Health Pharmacy Huaiyuan Pharmacy Fushoutang Pharmacy Dongfeng Pharmacy
Before the computerized management network is put into operation, the insured persons' visits to the doctor, purchase of medicines and settlement of expenses will be handled according to the following procedures. The settlement of expenses is handled according to the following procedures and requirements?
(I) Outpatient?
1. The insured person with the "Inner Mongolia Autonomous Region basic medical insurance certificate for workers", registers at the medical insurance registration window of the designated hospital, and receives a special outpatient prescription for basic medical insurance.
2. The outpatient physician receives the patient, inquires about the history of the disease, conducts a physical examination, and then writes a special prescription and a special examination and disposal order according to the condition of the patient.
3. The insured person goes to the pharmacy with the special outpatient prescription for basic medical insurance, and goes to the corresponding department with the special outpatient checklist and outpatient disposal order.
4. Participants in the outpatient medical care using individual accounts without accounting, cash settlement, settlement before taking medicine, examination or treatment.
5. Participants in the outpatient clinic, can be stamped with a designated hospital outpatient seal of the dispensing prescription to the designated retail drug purchase, the cost of which I and the designated retail pharmacies directly with cash settlement.
6. Before the computerized management network was put into operation, the individual account was temporarily managed by the insured unit, which filled in the relevant information form on a regular basis.
7. Outpatient treatment can be transferred to hospitalization due to the need of the condition.
(2) emergency?
1. The insured person with the "Inner Mongolia Autonomous Region basic medical insurance certificate for workers" to the basic medical insurance window or directly to the emergency room.
2. The physician will receive the patient, inquire about the medical history, conduct a physical examination and then issue a special prescription and a special examination, disposal and treatment order according to the condition.
3. The insured person goes to the pharmacy with the special prescription issued by the physician, and goes to the corresponding department with the special checklist and disposal and treatment orders.
4. Participants in the emergency room visit time is one day, in the emergency room consultation and treatment of the cost of the participant with cash directly with the hospital settlement, settlement before access to medicine, examination and treatment.
5. After the settlement of the emergency room consultation and treatment costs of the insured person, the unit with special receipts, special prescriptions, special inspection, treatment and disposal of diagnostic certificates to the autonomous region of medical insurance center for reimbursement procedures.
6. Participants in emergency medical treatment can also be stamped with a designated hospital outpatient seal of the dispensing prescription to the designated retail pharmacy to purchase drugs, settlement procedures with the outpatient settlement procedures.
7. The basic medical insurance fund will not pay for medical expenses incurred by insured persons due to alcoholism, automobile accidents and fights.
(C) hospitalization?
1. The insured person shall register at the registration office with the "Basic Medical Insurance Certificate for Employees of the Inner Mongolia Autonomous Region".
2. The outpatient physician receives the patient, inquires about the medical history, conducts a physical examination, and then issues a hospitalization notice if the patient's condition really requires hospitalization.
3. The insured person is admitted to the hospital, and the hospitalization office is responsible for keeping the "Inner Mongolia Autonomous Region Basic Employee Medical Insurance Certificate" and charging an appropriate deposit according to the condition of the patient.
4. After hospitalization, the hospitalization settlement office of the designated hospital will deduct the individual's out-of-pocket expenses from the hospitalization deposit according to the special hospitalization prescription, special examination and disposal treatment order, and the part paid by the integrated fund will be recorded in the account.
5. Participants hospitalized in the medical costs incurred, a part of the self-payment, before the computer network, do not use the individual account funds, always with cash and fixed-point medical institutions, the integrated fund part of the payment of the account, fixed-point hospitals regularly with the Inner Mongolia Medical Insurance Center in accordance with the agreement settlement.
6. Participants in the designated hospital inpatient treatment during the hospital, using the designated hospital hospital inpatient dispensing prescription to the designated retail pharmacy to buy drugs, the pharmacy price billing, issued a detailed list of drug purchases, the cost of the designated hospital according to the designated retail pharmacy issued a detailed list of drug purchases with the designated retail pharmacy billing, the cost of purchasing medicines and hospitalization expenses.
7. For the first time a participant is hospitalized in a designated medical institution for the first time within one year or in case of emergency rescue, the starting payment standard of the integrated fund shall be:
800 yuan for Level 3A hospitals, 600 yuan for Level 3B hospitals, and 400 yuan for hospitals of Level 2A and below. For those who are hospitalized several times within a year, the starting payment standard from the second hospitalization will be reduced by 20% from the starting payment standard of the first hospitalization. The maximum amount of medical expenses that can be paid by the integrated fund in one year is 25,000 yuan, and medical expenses above the maximum payment limit are solved through the establishment of large medical insurance.?
8. The proportion of payment by the coordinated fund of the insured is as follows:
Hospitalization medical expenses Proportion of payment by the coordinated fund of active employees (%) Proportion of payment by the coordinated fund of retirees (%)
Triple A hospitals, triple B hospitals, other hospitals, triple A hospitals, triple B hospitals, other hospitals
Starting line-5,000 yuan 70 75 80 75 80 85
5001-10000 RMB 75 80 85 80 85 90
10001-15000 RMB 80 85 90 85 90 95
15001-20000 RMB 75 80 85 80 85 90
20001 or more than 70 75 80 75 80 80 85
9. The hospitals in which the participants are staying have been found to be technically and technologically unsound. If the diagnosis is not clear or the treatment is difficult due to the technical and equipment limitations of the designated hospital, and the participant needs to be transferred to a higher designated hospital or specialized hospital in the city, the designated hospital will issue a diagnosis certificate, the attending physician will fill in the referral approval form, and the head of the department and the director in charge of the department will sign and stamp the form, and the transfer will be allowed only after the approval of the Autonomous Region's Health Insurance Center, and the medical expenses incurred before and after the transfer will be settled according to the one-time hospitalization expenses.
10. Participants need to be transferred to hospitals outside of the city, need to be organized by the Inner Mongolia Hospital or the First Affiliated Hospital of the Inner Mongolia Medical College consultation, put forward the opinion of the transfer, provide detailed diagnostic materials and fill out the "basic medical insurance participants to foreign hospitals for examination and approval form", the designated medical institutions, the medical insurance department audit and registration, the signature of the director in charge of the autonomous region of the Medical Insurance Center for approval, agreed to be transferred only after the transfer. Only after the transfer of hospitals, the hospitals transferred must be public hospitals at or above the county level, and the proportion of hospitalization medical fees paid by the integrated fund will be reduced by 10% on the basis of Article 8.
11. During the period of hospitalization, the insured person shall use the diagnostic and therapeutic items for which the basic medical insurance pays part of the expenses according to the doctor's prescription, and shall fill in the Special Examination and Approval Form and the Special Treatment Approval Form, and shall use them only after they have been approved by the autonomous region's medical insurance center.
12. The insured person for the discharge settlement procedures, the designated hospital settlement office to the insured person to open the discharge statement, the individual out-of-pocket part of the cash settlement, the part of the integrated fund payment by the hospitalization settlement office of the accounts with the autonomous region of the medical insurance center on time, the hospitalization settlement office should be registered in the Inner Mongolia Autonomous Region of the workers of the basic medical insurance certificate calendar "of the hospitalization of the medical expenses summary list, stamped with the hospital seal, the family or I signed and approved. Family members or I signed and recognized. I answered if you can adopt Thank you