Bedside hemofiltration (CRRT), adapted to critically ill patients or the need to do bedside (can not be moved), but there is no single water treatment hospital. CRRT generally can not be reported, only a very few provinces can (such as Zhejiang, Chengdu), you can use HDF, reimbursement rate of 45%, two HD can be reported once HDF.
Social health insurance is the state and society in accordance with certain laws and regulations, in order to provide protection to the scope of coverage of the workers in the event of illness of the basic medical needs of the protection of the social insurance system. The social insurance system is established by the state and society in accordance with certain laws and regulations.
Composition of social integrated medical insurance: the contribution base is M: the employee's wage income + allowances. The unit pays 8%M per year; the individual employee pays 2%M per year;
The unit pays 8%M:6.6%M to 7%M into the coordinated account (1%M to 1.4%M into the individual account)--inpatient costs; the individual pays 2%M:2%M into the individual account (plus the unit pays 1%M to 1.4%M)--outpatient costs
Has the following characteristics
Featured by "low level, wide coverage", the contribution is based on the low level of the vast majority of units and individuals can afford to pay, wide coverage of all urban units and workers, employees of different nature of the unit can enjoy the right to basic medical insurance. Participants can enjoy the right to basic medical insurance for the rest of their lives after completing their contribution period. Secondly, basic medical insurance is characterized by the "two sides of the burden, combined with the unified account"; the "to determine the expenditure on the basis of income, revenue and expenditure balance" as the principle.
The benefits are based on uniform standards. The same conditions of access, the same charges, the same treatment, there is no difference between high and low. Employees' outpatient expenses can be deducted from their personal accounts, and after the deduction, the employees will pay by themselves. Employees' hospitalization expenses are reimbursed on a pro rata basis: 86% for 10,000 RMB expenses by tertiary hospitals; 88% for 10,000 to 20,000 RMB expenses by tertiary hospitals; and 92% for 20,000 to 40,000 RMB expenses by tertiary hospitals. If the employee does not get sick for several years in a row the personal account funds can be accumulated and rolled over.
There is a basic starting deductible for each hospitalization, which is $500 for Level I hospitals, $750 for Level II hospitals, and $1,000 for Level III hospitals, and these costs are the responsibility of the employee. Category A and B drugs are reimbursed on a sliding scale, imported drugs are not reimbursed, and you have to pay for them yourself if they exceed the 40,000 yuan coverage limit.
According to the Ministry of Human Resources and Social Security, due to the different levels of economic development of each city, which leads to different levels of medical consumption and health insurance policies, for example, the three major catalogs of medicine (drug catalog, diagnostic and treatment catalogs, and medical services) are not consistent across the region, and the proportion of payment of the health insurance account and the proportion of reimbursement for hospitalization are also different. This leads to a more cumbersome review of medical insurance claims in different places.
At present, China's insured persons who seek medical treatment in other places are mainly long-term travelers and retired workers who live with their children. They are in a different place for medical treatment, need to be in the local health insurance designated hospitals to issue a referral certificate, by the patient on the medical costs of advance payment, later with the bills back to the local health insurance department for reimbursement; if the city has a different audit agency and personnel, it must be reimbursed prior to the audit of the initial examination of the signatures of the auditors.
It is understood that many areas of the country's health insurance agencies in Beijing, Shanghai, Guangzhou and other major cities have health insurance agents or personnel. This co-management mechanism has also been recognized and promoted by the Ministry of Labor and Social Security.