1 Specific practices of price inspection
First, the establishment of price self-examination group.
In order to comprehensively understand the situation of medical service charges in our hospital, under the careful organization of the hospital leadership, the deployment of the Discipline Inspection Commission, inspection, auditing, nursing, pricing and other departments of the price self-checking group, the president of the pro-head, secretary of the Discipline Inspection Commission as deputy head of the Discipline Inspection Commission Secretary personally led the team of the hospital's prices for the implementation of the situation of systematic and comprehensive self-checking, and clearly stipulate that the departments, departments and departments in charge of medical prices are the first person responsible for the charges, the price of medical care. It is clearly stipulated that the person in charge of each department and section is the first person responsible for medical charges, and is responsible for the medical charges of the department, and the charge collector of each section is the directly responsible person, which makes up the price management system composed of the dean - the secretary of the Discipline Inspection Commission - the price self-inspection team - the person in charge of the department - the charge collector, and so on. The price self-checking work provides a guarantee for the smooth implementation of the work.
Secondly, the unification of ideas and understanding.
Using the hospital weekly meeting time, actively publicize the price policy, repeatedly emphasized that medical service charges are related to the immediate interests of the people, the hospital in order to compete in the market for long-term development, we must do legal, standardized charges, good faith service, any department can not only see their own immediate economic interests, to the detriment of the masses of the interests of the hospital's economic efficiency should be established to improve the quality of medical care, Expansion of medical services, improve the level of medical services on the basis. Because of the whole hospital up and down the unity of thought and understanding, thus laying a good ideological foundation for the smooth implementation of the price self-check.
Third, the comprehensive price self-check work.
Under the personal leadership of the Secretary of the Discipline Inspection Commission, the price self-inspection team of the hospital's medical service charges for a period of 20 days of comprehensive and detailed inspection, the scope of its inspection involves the hospital's clinical, medical technology, outpatient departments. The inspection took the form of sampling, the amount of sampling according to the implementation of the fees of each department varies, in order not to disturb the normal work of the clinical departments, the inspection object to the archived medical records, of which no less than five copies of each clinical department, as many as more than ten copies of the patient's medical records and one-day list based on the current standard of medical service fees for inspection, and against the doctor's orders, lists and test reports, requiring the consistency of the three lists; medical services and medical services, and medical services, and medical services, and medical services, and medical services. Requirements for three single consistent; medical technology, outpatient clinics randomly selected a certain number of applications for inspection or treatment orders, respectively, and the fee accounting linkage check to see its charges. During this period, **** sampling nearly two hundred medical records, if necessary, also took the way of on-site inspection, and the problems identified were categorized and sorted out, in a full investigation, communication, discussion, based on each of the problems put forward practical measures to rectify and report to the President of the Board of Directors for discussion and adoption.
Fourth, for the problem, the deadline for rectification, tracking and review.
According to the spirit of the President's Office, for each problem, each department, by the price self-examination group issued a notice of rectification, requiring the relevant departments in accordance with the rectification measures to seriously rectify, and by the price self-examination group is responsible for tracking and inspection, the hospital leadership in the weekly meeting of the hospital in the real-time notification of the review, the rectification of the situation.
Fifth, consolidate the results, the establishment of price supervision and inspection of long-term mechanism.
In order to consolidate the results, after the centralized surprise inspection, the price management office of the hospital's medical service charges for a long period of self-examination, self-correction work, and weekly time unit, to the secretary of the Commission for Discipline Inspection and the relevant hospital leaders to report in writing to the self-examination, self-correction situation. Hospital leaders use the hospital weekly meeting time to inform the self-check, self-correction results, and the price of the implementation of standardized departments to put forward praise for the existence of irregularities in charging behavior of the department named criticism, at the same time, in order to ensure that the self-check, self-correction of the work of the implementation of a strong, to formulate and improve the medical services irregularities in charging the penalties, which stipulates that: for those who do not rectify the deadlines, once detected, the hospital weekly meeting to inform the criticism, in addition to unconditional return of the overcharged patient In addition to the unconditional return of overcharged patients, depending on the severity of the case, impose a fine of 1-5 times the amount of violations. Thus, for the self-correction work to provide a system to ensure the smooth implementation of the work.
Sixth, from the aftermath of the management to the control of the change, and effectively safeguard the interests of the masses
After a surprise centralized inspection, the hospital's medical service charges basically to standardize, although the archived medical records of the random inspection, will not disturb the normal work of the clinical departments, but to find out the problems of the patient has been discharged from the hospital and the correction of the difficulty, or can not be corrected, the losses caused by the patients, it is difficult to recover. It is difficult to recover, for this situation, we have launched a price site checking work, in addition to the normal random inspection of archived medical records, monthly by the Price Management Office of the medical service charges on-site checking, medical records out of the Department of the aftermath of the management of the change to the Department of the guidance of the incident control, found that the problem of timely corrections, and truly safeguard the people's vital interests. Specifically: in order not to affect the normal work of clinical departments, the inspection time is generally placed in the afternoon, in the morning by the full-time price staff through the hospital's price management terminals to carefully check the inspection department's list of in-hospital patient costs, to understand the charges, the charges are suspicious of the cost of the list printed out as a subject of inspection, in the afternoon, by the full-time price staff in person to the department, will be printed out the list and the patient's medical records. In the afternoon, the full-time price officer will visit the department in person, check the printed list and the patient's medical record on the spot, and when problems are found, verify with the fee-paying staff on the spot in a timely manner, guide and regulate the fee-paying behavior, ask them to correct on the spot or within a day's time and record the inspection situation, and if necessary, contact the head nurse of the department to ask for a unified standardization of the fee-paying behavior of the department. After the inspection, full-time price staff according to the price inspection records through the microcomputer to view the deadline for rectification, the deadline is not rectified, in accordance with the medical services in violation of the charges for penalties to be punished. One of the monthly *** random inspection of eight departments, random inspection of sixteen medical records.
Seventh, the formation of a virtuous cycle of price management workflow.
The inspectors find out the problem, timely and clinical, medical technology, outpatient and other charging departments to communicate, feedback, unity of thought, unity of knowledge, unity of understanding, there are differences of opinion, in a timely manner, request higher price authorities, the formation of the inspection - timely feedback, communication - unity of knowledge, unity of understanding, differences of opinion - request higher price authorities. Differences of opinion - please consult the higher price authorities - and then feedback to the charging section of such a virtuous cycle of workflow. In the process of self-checking, the new medical service projects ready to be carried out require the department in accordance with the requirements of the competent department, carefully fill out the cost of new medical service projects costing form, the price management office for project costing, timely application for reporting, no approval before, are not allowed to charge.
2 through the hospital internal price inspection, achieved a win-win result for clinical departments and full-time price staff
On a regular basis, the price management department, once the verification of clinical departments with irregular charges, generally rely on penalties to urge corrective action and strengthen the management of the clinical departments that the department can not sympathize with the busy clinical front line, will only use the authority to criticize the withholding of punishment of 121, the full-time price staff this way of working is also very anti-poverty, and the price management department is also a good way of working. The clinical departments thought that the functional departments could not sympathize with the busyness of the clinical front line and would only use their authority to criticize and deduct penalties.121 They also resented this way of working of the full-time price staff. Through on-site verification, the full-time price officers publicize the price policy on-site, correct the errors and deviations in the understanding of the price policy by the fee-charging staff in a timely manner, and actively consult and discuss with each other on issues that both sides disagree on. If necessary, the full-time pricing personnel can observe the operation process of medical services on site, which is conducive to improving the correct understanding of the full-time pricing personnel of medical service charge items, and at the same time, according to the needs of the clinical front-line work, the use of information management means, the price of easy to misoperate the options and parameters to increase the prompt information, to reduce the operational errors. This method not only promotes the understanding of price management work in clinical departments, but also helps full-time price staff to enhance the concept of service for patients, for the first line, always from the patients, from the perspective of the first line to consider the problem, and try to provide them with the convenience of their work, by the clinical departments and full-time price staff welcome, and achieve win-win results.
Through the inspection, the hospital up and down to improve and unify the understanding, standardize the behavior of medical service charges, charging department on the charges of the doubt, can timely and actively consult the full-time price staff, full-time price staff in the inspection process in-depth department, on-site office, full communication, repeated consultations, increase the charges of the staff of the national pricing policy and the connotation of the medical service projects a correct understanding of not only the price policy and medical service projects to play the role of full-time price staff in the inspection, but also to improve the quality of medical services. The full-time price staff in the price management process of guidance, supervision role, but also improve the clinical, medical technology, outpatient and other charging departments to charge the correct conscientiousness, creating a full participation in the hospital price management of the working atmosphere, so as to better price management has laid a solid foundation.