What is the standard of medical insurance?

In order to speed up the implementation of 15 information business codes for medical insurance disease diagnosis and surgical operation, medical service items, medicines, medical consumables, etc. in the county, realize the national mutual recognition of medical insurance business information codes, information interconnection and sharing, and serve the reform of medical security system and various business work, this year, Lianshui County Medical Insurance Bureau actively strengthened its work measures, vigorously promoted the implementation of standards, and helped.

The first is to clarify the work objectives and responsibilities. Strengthen organization and leadership, clarify the work schedule, division of responsibilities and work requirements, conscientiously implement the new development concept, integrate into the new development pattern, ensure the accurate implementation of the medical insurance information business code in the city, and complete the objectives and tasks. The second is to clarify the importance of medical insurance standards. This work is related to people's livelihood and should be promoted as a whole, and the work is interrelated. All designated medical institutions need to attach great importance to it, compact their responsibilities, and work together with Qi Xin to implement all the work. The third is to clarify the communication channels of business docking. Establish QQ group and WeChat group, strengthen communication and interaction, give timely feedback on the problems of code maintenance, ensure orderly and error-free work, and ensure the accuracy of code maintenance.

On1October 30th, 2020, 165438, the State Medical Insurance Bureau issued the Notice on Implementing 15 Medical Insurance Information Business Coding Standard, which emphasized the implementation of 15 Medical Insurance Information Business Coding Standard for disease diagnosis and surgical operation, medical service items, medicines and medical consumables. From the hospital's point of view, the workload of implementing medical insurance standards is huge, especially for medical consumables with complex specifications. Most hospital consumables codes are one code corresponding to multiple product specifications, but the granularity of the national medical insurance bureau code is finer, and one code corresponds to one product specification, which requires medical workers to complete the decomposition of the original code in addition to coding comparison. There are probably several solutions on the market at present. One is that the hospital compares itself and maps one by one. The other is to rely on third-party service providers to efficiently complete coding mapping through information systems. Taking Wanghai Kangxin, which started this business earlier in the industry, as an example, through real-time docking with the data in the coding database of the National Medical Insurance Bureau, the hospital can choose the comparison method according to its own situation. At that time, our hospital selected suppliers to assist in the comparison, and the overall progress was relatively smooth. We originally estimated that it would take more than 80 days, but in the end it only took more than 20 days, and the hospital leaders were very satisfied.