3A hospitals: Inner Mongolia Hospital, First Affiliated Hospital of Inner Mongolia Medical College, Inner Mongolia Mongolian Chinese Medicine Hospital.
253rd Hospital of PLA?
Sanyi Hospital: First Hospital of Hohhot, Central Hospital of Hohhot Railway Bureau and Armed Police Corps Hospital?
Other hospitals: Xincheng District Hospital Yuquan District Hospital Suburb Hospital Inner Mongolia Civil Aviation Hospital
The First Hospital of Inner Mongolia Prison Administration The First Prison Hospital of Hohhot, Inner Mongolia
Inner Mongolia Hohhot No.2 prison hospital Hexi company staff hospital
Inner Mongolia University Hospital Inner Mongolia University of Technology Hospital Inner Mongolia Agricultural University Hospital
Out-patient department of Inner Mongolia Geological Exploration Bureau? Designated pharmacies:?
Zhongshan Drugstore Yonglingtang Drugstore Lian Drugstore Railway Drugstore Tongren Drugstore Meng Kai Railway Bureau Hospital Medicine Retail Department Huayu Drugstore Zhonglian Drugstore Headquarters Xiao Zhao Drugstore
Aimin drugstore xinteyao drugstore health drugstore Huaiyuan drugstore fushoutang drugstore Dongfeng drugstore
Two, before the computer management network is put into operation, the insured medical treatment, drug purchase and expense settlement shall be handled according to the following procedures and requirements?
(1) clinic?
1. The insured holds the Certificate Calendar of Basic Medical Insurance for Employees in Inner Mongolia Autonomous Region, registers at the medical insurance registration window of the designated hospital, and receives the special prescription for basic medical insurance outpatient service. ?
2. Outpatient doctors receive consultation, ask about medical history, and after physical examination, issue special prescriptions, special inspections and disposal orders according to the condition. ?
3. The insured to the basic medical insurance special outpatient prescription to the pharmacy price comparison, special outpatient checklist, outpatient disposal list respectively to the corresponding department price comparison. ?
4. Insured persons who use personal accounts to seek medical treatment in outpatient clinics do not keep accounts, but settle accounts in cash, and can only take medicine, check or treat after settlement.
5. When the insured person goes to the outpatient clinic for medical treatment, he can buy medicine at the designated retail outlets with the external prescription stamped with the special seal of the designated hospital outpatient clinic, and the expenses will be settled directly by himself and the designated retail pharmacy in cash. ?
6. Before the computer management network is put into operation, the personal account shall be temporarily managed by the insured unit, and the relevant information form shall be filled in on schedule. ?
7. Outpatient treatment can be turned into hospitalization due to illness. ?
(2) emergency?
1. Insured persons shall register at the special window for basic medical insurance or go directly to the emergency room with the calendar of basic medical insurance vouchers for employees at the same level in Inner Mongolia Autonomous Region. ?
2. The doctor accepts, asks about the medical history, and after the physical examination, makes a special prescription according to the condition, and makes a special inspection, disposal and treatment list. ?
3. The insured to the pharmacy with a doctor's special prescription, special checklist, disposal treatment list to the corresponding departments. ?
4. The insured's emergency treatment time is 1 day, and the expenses for emergency treatment shall be settled directly with the hospital in cash by the insured, and the medicine can be taken, examined and treated only after the settlement. ?
5. After the expenses of emergency medical treatment of the insured are settled, the unit shall go through the reimbursement procedures with special receipts, special prescriptions, special inspection, treatment and disposal vouchers to the medical insurance center of the autonomous region. ?
6. When the insured person goes to the emergency department for medical treatment, he can also buy medicine from the designated retail pharmacy with the external prescription stamped with the special seal of the designated hospital outpatient service. The settlement procedure is the same as that of the outpatient service. ?
7. The basic medical insurance fund will not pay the medical expenses incurred by the insured due to alcoholism, car accidents and fights. ?
(3) hospitalization?
1. The insured shall register at the registration office with the Certificate Calendar of Basic Medical Insurance for Employees in Inner Mongolia Autonomous Region. ?
2. Outpatient doctors receive consultation, ask about medical history, and after physical examination, issue a notice of hospitalization according to the actual need for hospitalization. ?
3. The insured person shall go through the admission formalities, and the inpatient department shall be responsible for keeping the Basic Medical Insurance Certificate Calendar for the employees at the same level in Inner Mongolia Autonomous Region, and collect the appropriate deposit according to the illness. ?
4. After hospitalization, the settlement office of the designated hospital will subtract the expenses paid by the individual from the hospitalization deposit according to the hospitalization special prescription, special inspection and treatment list, and co-ordinate the account of the fund payment part. ?
5. The medical expenses incurred by the insured in hospitalization belong to the self-paid part, which shall be settled with the designated medical institutions in cash before the computer networking, and the designated hospitals shall settle with the Inner Mongolia Medical Insurance Center regularly according to the agreement. ?
6. During the hospitalization of the insured in the designated hospital, the insured shall purchase medicines from the designated retail pharmacies with the prescriptions of the designated hospitals, and the pharmacies shall plan the prices, keep accounts and issue a detailed list of medicines. The expenses shall be settled with the designated retail pharmacies by the designated hospitals according to the detailed list of drugs issued by the designated retail pharmacies, and the drug purchase expenses shall be included in the hospitalization expenses. ?
7. If the insured is hospitalized or rescued in a designated medical institution for the first time within one year, the Qifubiaozhun for the overall fund is:
800 yuan, a third-class first-class hospital; 600 yuan, a tertiary hospital; Secondary and below hospitals in 400 yuan. For multiple hospitalizations within one year, the Qifubiaozhun for the second hospitalization is reduced by 20% on the basis of the Qifubiaozhun for the first hospitalization. ? The maximum amount of medical expenses that can be paid by the overall fund within one year is 25,000 yuan, and the medical expenses above the maximum amount can be solved by establishing large medical insurance. ?
8. The proportion of the insured's overall fund payment is as follows:
Proportion of on-the-job employees' overall fund to pay hospitalization medical expenses (%) Proportion of retirees' overall fund to pay (%)
Tertiary hospitals, tertiary hospitals and other hospitals, tertiary hospitals and other hospitals
Deductible -5000 yuan 70 75 80 75 80 85
500 1- 10000 yuan 75 80 85 80 85 90
10001-15000 yuan 80 85 90 85 90 95
1500 1-20000 yuan 75 80 85 80 85 90
Above 200065438+ 0 yuan 70 75 80 75 80 85
9. Where the insured lives in a designated hospital due to technical and equipment limitations, and the diagnosis is unknown or the treatment is indeed difficult, and needs to be transferred to a designated hospital at the next higher level in the city for diagnosis and treatment, the designated hospital will issue a diagnosis certificate, the attending physician will fill in the referral approval form, and the director and the competent dean will sign and affix their seals before the transfer, and the medical expenses incurred before and after the transfer will be settled according to the hospitalization expenses. ?
10. If the insured person needs to be transferred to a hospital outside the city for treatment, he should organize a consultation with Inner Mongolia Hospital or the First Affiliated Hospital of Inner Mongolia Medical College, put forward the opinion of transfer, provide detailed proof of diagnosis and fill in the Approval Form for the Insured to Be Transferred to a Hospital Outside the City. The medical insurance department of designated medical institutions shall review and register, and report to the medical insurance center of the autonomous region for examination and approval after being signed by the dean in charge. Only after approval can he/she be transferred. The transfer-out hospital must be a public hospital at or above the county level?
1 1. During hospitalization, the medical treatment items that the insured uses the basic medical insurance to pay part of the expenses according to the doctor's advice need to fill in the Approval Form for Special Examination and the Approval Form for Special Treatment, and can only be used after being approved by the medical insurance center of the autonomous region. ?
12. The insured person goes through the discharge settlement formalities, and the settlement office of the designated hospital issues a discharge settlement form for the insured person. The individual pays part in cash, and the overall fund payment part is accounted for by the hospitalization settlement office, and settled on time by the medical insurance center of the autonomous region. The hospitalization settlement office will register the summary list of hospitalization medical expenses in the calendar of basic medical insurance vouchers for employees at the same level in Inner Mongolia Autonomous Region, affix the official seal of the hospital, and be signed and approved by family members or myself. I'll accept it if I can. Thank you.