The basic process of medical insurance code standardization

In order to accelerate the implementation of the unified medical insurance information business coding standards, to achieve the standardization of medical insurance and information construction work "vertical all through, horizontal full coverage", the Municipal Bureau of Medical Insurance seriously study, carefully organized, carefully deployed, grasp the city's medical insurance business coding standardization work.

Clear organization and leadership, the formation of work force. The Bureau in time to set up a consistent standard working group and project task force, the development of the implementation of the program, the formation of medical insurance professional group, expert guidance group, technical support group, test run the initial inspection group of four working groups, a clear division of responsibilities, sorting out the project to promote the timetable, step by step to promote the consistent standard of work. The Bureau also set up the city's standardization work group, timely issuance of national coding materials, interface specifications and development manuals, coordinating and solving the city's work to promote the problems and difficulties, and do a good job of communication and publicity and guidance work. Regular communication to the city, county and district bureaus on the progress and effectiveness of the work, and constantly optimize the standardization of work capacity and management efficiency, to promote the application of business coding standards to achieve tangible results.

Clear work responsibilities, multi-level coordination and promotion. According to reports, the city, counties and districts, respectively, according to the division of responsibilities, the national health insurance information system in the health insurance system units, health insurance system staff, designated medical institutions, such as 15 business coding classification, specifically divided into the designated medical institutions at all levels and designated pharmacies, to do a good job of coordination and harmonization of work to ensure that the work is completed on time. At the same time, the Municipal Health Insurance Bureau held a promotional meeting, a detailed interpretation of the standardization work, the formation of a weekly reporting system, the city closely cooperate, follow the progress; the standardization of the working group went to the counties and districts to carry out training on the sentinel medical institutions, point to point to carry out the door-to-door guidance and question and answer session, timely and effective communication and feedback, and efficiently promote the standardization of the work.

Actively rising to the challenge to ensure a smooth transition. The relevant person in charge told reporters that, in order to understand the real situation, the Municipal Health Insurance Bureau actively visit the scene, for the visit process to understand the code mapping, the hospital end of the system transformation, the settlement list transformation and other problems, and timely convening of the counties and districts of the business coding acceptance of the promotion of the meeting, the municipal initial evaluation of the work of the meeting, etc., the problems found on-site solution. In addition, the Bureau took the initiative to the provincial bureau experts, has completed the task of standardization of the city, software development companies and other consulting exchanges, learning to summarize and refine the good experience, good practices, and promote the use of the city; comprehensive standardization of the work of the "double-code" test method to ensure that no error.