The coordinated areas shall generally carry out the validation of designated medical institutions according to the following procedures: first, the medical institutions willing to undertake basic medical insurance to the coordinated areas of the administrative departments of labor security to submit a written application and provide the review of the required supporting materials; second, the coordinated areas of the administrative departments of labor security of the qualification examination of the medical institutions that have made the application, qualified and issued a certificate of qualification and social announcement; third, the participants within the scope of the qualified medical institutions for individual medical treatment to choose. Qualified medical institutions issued by the designated qualification certificate and announced to the community; third, the insured person in the designated qualification of the medical institutions within the scope of the individual medical institutions to propose the choice of designated medical institutions, the employer unified summary reported to the coordinating area social insurance agency; fourth, the social insurance agency in accordance with the choice of the intention of the insured person to determine the coordinated designated medical institutions, and through the signing of a contract, including the service population, scope of service, service contents, service content, and the number of medical institutions, and the number of medical institutions. Fourthly, the social insurance agency will determine the designated medical institution according to the participants' intention to choose, and clarify the responsibilities, rights and obligations of both parties by signing an agreement that includes the service population, service scope, service content, service quality, settlement of medical expenses, medical expense payment standard, as well as the audit and control of medical expenses, and so on. Understanding medical institutions: Medical institution refers to the general term for health institutions established in accordance with legal procedures to engage in disease diagnosis and treatment activities. The meaning of this concept: first, medical institutions are health institutions established by law. Secondly, a medical institution is a health organization engaged in disease diagnosis and treatment activities. Third, medical institution is the general term for health institutions engaged in disease diagnosis and treatment activities. Medical institutions in China are composed of a series of health institutions that carry out disease diagnosis and treatment activities. Hospitals, health centers are the main form of medical institutions in China, in addition, there are sanatoriums, outpatient clinics, clinics, health clinics (rooms), and first aid stations, etc., *** with the composition of China's medical institutions.
Legal Objective:Article 14 of the Interim Measures for the Management of Medical Insurance Designation of Medical Institutions
Designated medical institutions shall strictly implement the medical insurance agreement, rational diagnosis and treatment, reasonable fees, strict implementation of the directory of medical insurance medicines, medical consumables, and medical service items, and other directories, giving priority to the use of medical insurance directory medicines, controlling the proportion of out-of-pocket expenses of the patients, and increasing the efficiency of the use of the medical insurance fund. (c) Utilization efficiency. The designated medical institutions shall not provide medical insurance settlement for non-designated medical institutions.
Costs not paid by the agency, the quality guarantee deducted by the designated medical institutions according to the agreement on medical insurance and its payment of liquidated damages, etc., the designated medical institutions shall not be dealt with as medical insurance arrears.