2. Fill in the Declaration of Designated Medical Institutions for Basic Medical Insurance for Urban Employees in Yueyang City;
3. Provide the original copy of the Practice License of Medical Institution and submit a copy;
4. Provide the original roster of all employees (including name, ID number, salary, etc., and indicate the insured status), labor contract and social insurance payment form of last month, and submit copies;
5. List of persons in charge of medical institutions (legal representatives) and medical insurance, contact persons, telephone numbers, setting of departments, list of persons in charge, telephone numbers, names and signatures of directors and deputy directors;
6. Certification materials that meet the accreditation standards of medical institutions;
7. Certification materials of drug supervision and administration and supervision and inspection by price departments;
8. provide the original qualification certificate and practice certificate of professional and technical personnel, and submit a copy;
9. The business income and expenditure of last year, the outpatient and inpatient services (including the number of outpatients, average medical expenses, number of inpatients, average hospitalization days of discharged patients, average hospitalization expenses of discharged patients, average daily hospitalization expenses of discharged patients, etc.), the number of existing beds, the standard level, the charging standards of various medical services and the price list of medicines implemented;
1. Submit the management regulations of medical institutions and other systems;
11. provide the original certificate of property right, certificate of use right or house lease contract of the medical service place, and submit a copy;
12. declare the geographical location map of the medical institution;
13. Other materials specified by the Medical Insurance Department of the Municipal Human Resources and Social Security Bureau (proof materials such as the unit's participation in five insurances).