Application background
With the continuous development and improvement of medical services, the medical insurance agreement plays an important role in protecting the rights and interests of the insured and regulating the behavior of medical services. The cooperative relationship between medical institutions and health insurance organizations needs to be clarified through the signing of health insurance agreements to clarify the rights and obligations of both parties. When the original medical insurance agreement is about to expire, the medical institution needs to submit a renewal application to the medical insurance institution to ensure the continuity and stability of medical services.
The application process
Preparation of application materials: Medical institutions need to prepare relevant application materials according to the requirements of health insurance organizations. These materials usually include the qualification certificates of the medical institutions, the list of medical service items, the list of medical equipment, the list of medical personnel, etc.
Submission of application materials: Medical institutions will submit the prepared application materials to the medical insurance organization. The method of submission can be online or offline, depending on the requirements of the local medical insurance organization.
Auditing the application materials: The medical insurance organization will audit the application materials submitted by the medical institution. The review mainly includes whether the qualification of the medical institution meets the requirements, whether the medical service program is compliant, and whether the medical equipment is complete.
On-site assessment: For medical institutions that have passed the audit, the medical insurance organization may conduct an on-site assessment. The assessment mainly includes whether the actual situation of the medical organization is consistent with the application materials and whether the quality of medical services meets the standards.
Signing of health insurance agreement: After the audit and assessment, the health insurance organization will sign a new health insurance agreement with the medical institution. The new agreement will clarify the rights and obligations of both parties and protect the rights and interests of the insured.
Third, notes
Application materials should be true, accurate and complete, and should not be falsified.
The application process should be carried out in accordance with the requirements of the health insurance organization and should not be changed without authorization.
During the review and assessment process, medical institutions should actively cooperate with the medical insurance organization and provide necessary support and assistance.
In summary:
The application for renewal of health insurance agreement is an important matter of cooperation between medical institutions and health insurance organizations. Medical institutions need to submit renewal applications to medical insurance organizations in accordance with relevant regulations and procedures, and submit true, accurate and complete application materials. After review and evaluation, both parties will sign a new medical insurance agreement to ensure the continuity and stability of medical services.
Legal basis:
The Law of the People's Republic of China on Social Insurance
Article 31 stipulates that social insurance administrators, in accordance with the needs of management and service, may sign service agreements with medical institutions and drug business units to regulate the behavior of medical services. Medical institutions shall provide reasonable and necessary medical services to insured persons.