First, the amount that can be reimbursed by the medical insurance is: reimbursement = (total medical expenses - out-of-pocket expenses - out-of-pocket payments - starting line) X reimbursement ratio, and the reimbursement ratio is about 85 percent. Secondly, if the person concerned incurs medical expenses exceeding the maximum payment limit of the basic medical care co-ordination fund, then the social insurance department will reimburse 85% of the expenses at the following rates: below 0-40,000 yuan, 90% of the expenses between 40,000 yuan and below 80,000 yuan, and 95% of the expenses above 80,000 yuan.
Legal basis: The Social Insurance Law of the People's Republic of China Article 30 The following medical expenses are not included in the scope of payment by the basic medical insurance fund:
(1) those that should be paid from the industrial injury insurance fund;
(2) those that should be borne by a third party;
(3) those that should be borne by public *** health;
(4) those that should be borne by public *** health;
(5) those that should be borne by public *** health. **health burden;
(iv) medical treatment outside the country.
Medical expenses shall be borne by a third person in accordance with the law, and if the third person fails to pay or if the third person cannot be identified, the basic medical insurance fund shall pay in advance. The basic medical insurance fund shall have the right to recover from the third party after the payment.
Tianjin Huanhu Hospital was established in 1988 as a municipal hospital specializing in neurosurgery, and was renamed Tianjin Brain Center Hospital in 1992, and Tianjin Neurosurgery Institute was established in 1993.
The hospital was recognized as a Grade 3A hospital in 1995 and one of the "Top Ten" hospitals in Tianjin in 1998. The hospital covers an area of 18,480 square meters, with a building area of 25,427 square meters, of which 3,981 square meters are for outpatient and emergency services and 9,478 square meters are for inpatient services. The hospital has 794 employees, including 645 professional and technical personnel, 35 with master's degree or above, 91 with deputy senior title and above, and 174 with intermediate title. The hospital has 508 open beds and equipment worth 120 million yuan. There are more than 9,000 inpatients and 100,000 outpatients annually, and it carries out more than 2,000 large and medium-sized surgeries every year.
Hospital culture and management of the hospital under the leadership of the President of the hospital only Dashi, the full implementation of modern hospital management system, adhere to the quality of education, comprehensive and scientific promotion of diversified, interactive, allegorical way of education, so that workers in the ideological and political, scientific and technological, physical and psychological qualities of the overall improvement. The hospital emphasizes cultural construction, uses advanced culture to educate and shape people, uses the power and way of culture to manage the hospital, and forms an open, innovative and diversified hospital culture. After studying "Who Moved My Cheese", it gives the whole hospital staff a sense of crisis and responsibility.
After that, it drew on the "Management of 24 Carrots" to improve the hospital's incentive mechanism. With wisdom-filled appreciation incentive mechanism to protect staff enthusiasm, enhance loyalty, stimulate efficiency, so that labor, knowledge, talent, creation is respected and loved. Fully reflect the value of knowledge, talent, labor, so that tangible inputs to get intangible outputs, the formation of everyone in the hospital as a home, the hospital as a proud, dedicated to their jobs, striving to create a first-class group image.