The agency should do a good job of publicizing and training the operating procedures of the designated medical institutions ( ) health insurance policy, management system, payment policy.
I. Publicity and training on medical insurance policies:
Policy interpretation: The operator should interpret the latest medical insurance policies to the designated medical institutions, including the background, purpose, specific content and implementation time of the policy, etc., to ensure that the medical institutions understand the ins and outs of the policy.
Notification of policy changes: Timely release of any changes to the policy to medical institutions, including adjustments to reimbursement rates, increases or decreases in reimbursement programs, etc., to keep the information flowing.
Interpretation of policy documents: For specific provisions in the policy documents, the operator should make detailed interpretation to help medical institutions correctly understand the policy requirements.
Second, the management system of publicity and training:
Reimbursement process: a detailed introduction to the reimbursement process of medical services, including the patient's visit to the hospital, the medical institution reimbursement application, the funds to pay the various links.
Medicare card use: training on how to use the card and precautions to be taken to ensure that healthcare organizations handle patients' cards correctly.
Information entry standards: Communicate information entry standards to medical institutions to ensure accuracy and avoid reimbursement problems caused by incorrect information.
Third, publicity and training on payment policies:
Payment methods: Explain the payment methods for medical services, including prepayment, post-payment, and per-project payment, etc., and help medical institutions understand the scenarios in which each method is applicable.
Payment Cycle: Explains the cycle of Medicare payments so that providers understand when to expect to receive Medicare payments.
Payment Criteria: Providers are regularly updated on the criteria for Medicare payments to ensure that they are correctly filled out when issuing receipts.