A designated medical institution is an important concept in China's social medical insurance system, and it is also an important stakeholder of medical institutions, medical insurance participants and their families. According to the regulations of the National Medical Insurance Bureau, the designated medical institutions of Class A shall meet the following conditions: 1. Medical institutions with legal business licenses, such as the Practice License for Medical Institutions issued by the Health Bureau; 2. Have high medical level and professional skills, such as scale, beds, medical facilities, medical staff and other indicators; 3. Being able to provide various basic medical services such as prevention, diagnosis, treatment and rehabilitation for medical insurance participants; 4. Sign an agreement with the local medical insurance department to provide traceability, audit, supervision and management of related expenses and management information. As an important supporting institution of the medical insurance system, Class A designated medical institutions need to undertake more medical services and responsibilities while enjoying the preferential policies with the highest medical insurance payment standard. Medical insurance participants can enjoy more comprehensive, high-quality and low-cost basic medical security services.
What's the difference between Class A designated medical institutions and Class B and C medical institutions? A-class designated medical institutions, B-class designated medical institutions and C-class designated medical institutions are three levels in the medical insurance system, which respectively correspond to different medical services and medical insurance payment standards. Among them, Class A designated medical institutions have the characteristics of larger scale, higher medical level, wider service scope and higher payment standard. Class B designated medical institutions are relatively small, with professional clients and low payment standards; Class C designated medical institutions are mainly rural grass-roots medical institutions, serving farmers and urban and rural residents, with the lowest payment standard. Different levels of medical institutions have different qualifications and management requirements.
A designated medical institution is one of the important concepts in China's social medical insurance system. It is of great significance as a supporting institution for basic medical services and a welfare guarantee institution for medical insurance participants. Medical insurance participants should understand the characteristics, advantages and disadvantages of different levels of medical institutions, and rationally choose medical services and channels to provide better protection for their own health and family financial planning.
Legal basis:
People's Republic of China (PRC) Social Insurance Law Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance to protect citizens' right to get material help from the state and society in the event of old age, illness, industrial injury, unemployment and maternity. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.