2, master all levels and types of medical insurance policy, in accordance with the medical insurance agencies at all levels of approval of the medical program and payment standards for review and settlement.
3, effectively do a good job in the medical insurance hospitalized patients of the costs of the audit work.
Medicare fee settlement management system:
1, in strict accordance with the provisions and the specific requirements of the medical insurance agencies at all levels, to do a good job in the settlement of the costs of patients with medical insurance.
2, master all levels and types of health insurance policy, in accordance with all levels of health insurance agencies to approve the medical items and payment standards for review and settlement.
3, effectively do a good job in the medical insurance hospitalized patients of the costs of the audit work.
4, strict implementation of admission and discharge standards, not to break down the number of hospitalizations, not to shirk the responsibility of critically ill patients, and not to the detriment of the interests of insured employees.
5. Strengthening the settlement and management of medical insurance expenses, timely contact with medical insurance agencies at all levels, and coordinating and solving the problems arising from the settlement of medical insurance expenses.
6, in accordance with the requirements of the medical insurance agencies at all levels of timely submission of statements, regular reconciliation with the Finance Section, and do a good job of archiving information, binding and preservation of the work.
What are the items included in the medical insurance reimbursement
The classification of medical insurance reimbursement and the items included are as follows:
1, general medical insurance. It mainly includes outpatient expenses, medical expenses, examination expenses, and so on.
2, hospitalization insurance. It mainly covers daily hospitalization fee, cost of utilizing hospital equipment, surgery cost, medicine cost, etc.
3. Surgical insurance. Provides for all expenses incurred due to necessary surgery required by the patient.
4. Comprehensive medical insurance. Its cost coverage includes all costs of medical treatment and hospitalization and surgery, etc.
5, special disease insurance. Certain special diseases often bring the patient a catastrophic cost payment, the average resident family can hardly afford. Examples include cancer and heart disease. Provide coverage for policyholders of major diseases, can be a single, such as malignant tumors, or even malignant tumors in a certain number of cancers.
I hope the above can help you, if you have other questions please consult a professional lawyer.
Legal basis:Social Insurance Law, Article 28
In line with the basic medical insurance drug catalog, diagnostic and treatment items, medical service facility standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.
Article 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administrative organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.