(A) designated application:
Medical institutions to submit a designated application, the medical insurance agency immediately accepted. If the application materials are incomplete, the medical insurance agency will inform the medical institution to supplement the materials within 5 working days from the date of receipt.
(2) Comprehensive assessment:
The medical insurance agency organizes an assessment team or commissions a third-party agency that meets the requirements to carry out the assessment in writing and on-site. The assessment team is composed of professionals in medical insurance, medicine and health, financial management and information technology. The assessment will take no more than three months from the date of acceptance of the application materials, and the time taken by the medical organization to supplement the materials will not be counted as part of the assessment period. The assessment includes:
1. Verification of the license of medical institutions or Chinese medicine clinic filing certificate or military medical institutions for civilian service license;
2. Verification of physicians, nurses, pharmacy and medical technology and other professional and technical personnel practice information and the first place of registration of the physician information;
3. Verification of diagnosis, treatment, surgery, hospitalization, drug storage and issuance, inspection, testing and radiology infrastructure appropriate to the function of services
4. Verification of the internal management system and financial system corresponding to the medical insurance policy, the results of the assessment of medical institutions by the health department;
5. Verification of whether the information system of the medical institutions related to medical insurance has the conditions to carry out direct network settlement.
The assessment results are categorized into qualified and unqualified. For those who fail the assessment, they shall be informed of the reasons and suggestions for rectification shall be made. From the date of delivery of the results of the notification, rectification of three months after the assessment can be re-organized, the assessment is still unqualified, 1 year shall not re-apply.
(3) External publicity:
For those qualified in the assessment, the health insurance administration organization will include the list of medical institutions to be included in the health insurance agreement, and the list will be publicized on the portal of the municipal health insurance administration department for a period of 5 working days.
(4) Consultation and negotiation and installation of information system:
After the public announcement of no objections, the health insurance administration agency and the medical institutions to be signed health insurance agreement consultation and negotiation, and reached an agreement, the medical institutions in accordance with the provisions of the installation of health insurance information system.
(E) Signing of the health insurance agreement:
The health insurance information system is installed after the normal operation of the medical institutions, sign the integrity of the service commitment, the health insurance agency and its signing of the health insurance agreement.
(F) Information Publication:
The medical insurance administrative organization will publish information on the designated medical institutions that have signed the medical insurance agreement, including their names and addresses, for the insured to choose.