1, information required to declare chronic diseases:
(1) According to the diagnosis, the doctors above the deputy director of the municipal hospital;
(2) Copies of medical records (including homepage, discharge summary, operation records, pathological reports of tumor patients) and relevant inspection reports;
③ Copy of ID card (copy to A4 paper size);
④ Two recent bareheaded color photos;
(5) fill in the municipal medical insurance designated chronic disease (serious illness) application form.
Step 2: The Municipal Medical Insurance Bureau and the handling windows of the district branches will conduct a preliminary examination of the materials declared by patients with chronic diseases.
1, qualified in the first trial: according to the chronic disease identification standard of the Municipal Medical Insurance Bureau, the information provided by the chronic disease applicant will be reviewed. To provide complete information and meet the criteria for the identification of chronic diseases, each district branch shall sort out the information of applicants who have passed the preliminary examination and report it to the special care department of the Municipal Medical Insurance Bureau.
2. Unqualified in the first trial: According to the chronic disease identification standard of the Municipal Medical Insurance Bureau, if the materials provided by the chronic disease applicant do not meet the identification standard, the Municipal Bureau and the district branches will promptly return the application materials to the chronic disease applicant or the reporting unit, and explain the reasons for the non-conformity.
Step 3: The Municipal Medical Insurance Bureau will uniformly organize the verification of the application materials for chronic diseases.
1. Verification is qualified: the Municipal Medical Insurance Bureau organizes the access verification of the application materials of patients with chronic diseases. To verify the authenticity and reliability of the materials, according to the classification of diseases, into the medical arrangement.
2. Unqualified verification: those who are found to be fraudulent in the entrance verification will not be included in the medical examination arrangement, and will be returned to the applicant and the applicant, and the eligibility of the insured to declare chronic diseases within three years will be cancelled.
Step 4: The Municipal Medical Insurance Bureau classifies the diseases that need to be examined and contacts the physical examination hospital.
The special care department of the Municipal Medical Insurance Bureau classifies the people who declare chronic diseases in the city according to the diseases they participate in, arranges the numbers, determines the physical examination items of each disease, contacts the physical examination hospital, determines the physical examination time, and determines the work flow and division of labor of the staff.
Step 5: The Municipal Medical Insurance Bureau and each district branch bureau inform the patients with chronic diseases within their jurisdiction to participate in the physical examination.
The Municipal Medical Insurance Bureau and the medical insurance sub-bureaus of all districts shall notify the applicants with chronic diseases who have passed the preliminary examination within their jurisdiction to participate in the physical examination of chronic diseases.
Step 6: Persons participating in the physical examination of chronic diseases shall designate hospitals to participate in the physical examination on time according to the time notified by the municipal or district medical insurance bureau.
The insured persons who take part in the physical examination of chronic diseases shall carry relevant materials, bring their own medicines and prepare the medical examination expenses according to the time notified by the Municipal Medical Insurance Bureau or the district medical insurance branches and designated hospitals. If it is inconvenient to move, it should be accompanied by family members and take part in the medical examination on an empty stomach. (Some diseases don't need an empty stomach, depending on the type of physical examination. After the participants arrive at the designated hospital, they should follow the arrangement of the staff of the medical insurance bureau and check one by one according to the workflow of participating in the inspection, and leave the inspection hospital after being allowed to go home after guidance, so as to avoid fewer inspection items.
Step 7: The Municipal Medical Insurance Bureau organizes experts to identify chronic diseases.
According to the classification of diseases, the Municipal Medical Insurance Bureau organizes different types of medical experts to identify them one by one according to the physical examination results of the insured persons with chronic diseases, combined with the application materials and on-site diagnosis, and according to the municipal chronic disease identification standards stipulated in the documents.
Non-physique appraisal: the materials of applicants with chronic diseases who have been identified as unqualified by experts are returned to the applicant or the applicant himself.
Step 8: The Municipal Medical Insurance Bureau will input the evaluation grade, disease type and other related information into the system for the patients with chronic diseases who have passed the expert evaluation, and generate the card number of chronic diseases. And make chronic disease cards.
According to the identification results of medical experts, the staff of the special care department of the Municipal Medical Insurance Bureau will input the diseases and grades of the chronically ill people into the medical insurance information system, generate the chronic disease card number, and notify the relevant staff in each district to organize the production of chronic disease cards in a unified way.
Step 9: The Municipal Medical Insurance Bureau and the medical insurance sub-bureaus of all districts publicize the identified patients with chronic diseases, issue chronic disease cards, and the patients with chronic diseases purchase chronic disease prescriptions.
The Municipal Medical Insurance Bureau and the district medical insurance sub-bureaus publicized the results of the identification of chronic diseases on the Daqing human resources and social security network, and accepted the report. The municipal medical insurance bureau and the district medical insurance bureaus notify those who have identified chronic diseases to receive chronic disease cards.