Reimbursement system of new rural cooperative medical system
First, farmers who participate in cooperative medical care, with cooperative medical care family account card, receive vaccination or preventive health care services in town health centers, that is, get on-site compensation, and the maximum compensation amount does not exceed the total amount of funds in family account.
Two, to participate in the cooperative medical care of farmers, holding a cooperative medical certificate in the town hospital outpatient treatment, inspection and other preferential fees, directly in the hospital outpatient relief.
Third, hospitalization reimbursement: the principle of paying first and then reimbursing.
1, reimbursement procedure
Hospitalization in urban hospitals, with the disease certificate, valid invoice, cost list, cooperative medical care certificate, resident ID card or household registration book, etc. for reimbursement procedures.
To the district and municipal medical institutions for hospitalization, there must be a transfer certificate issued by the town and district hospitals, and approved by the district joint management office.
All reimbursement procedures are handled in the town management office. The staff of the joint management office strictly examines the reimbursement voucher, and the reviewer must sign it. At the same time, the reimbursement person must sign the reimbursement form, and then the director of the joint management office can sign it before reimbursement.
2. Reimbursement time: every polder day in this town will be reviewed and reimbursed.
3. The Town Co-management Office will send the reimbursement invoice and hospitalization expense list of last month to the District Co-management Office for verification and go through the reimbursement procedures before 10 and 25th of each month.
Reimbursement Procedure of New Rural Cooperative Medical System in Maogang District
1. Relevant procedures to be submitted: the reimburser shall submit the reimbursement to the town management office with the procedures such as diagnosis certificate of hospitalization, referral certificate, valid invoice, hospitalization expenses list, cooperative medical certificate, resident ID card or household registration book.
2. Reimbursement procedure: go to the town joint management office with relevant procedures to fill in the reimbursement list → the joint management office will review and fill in the reimbursement amount in proportion → the auditor's signature → the accountant's signature → the claimant's signature → the director of the joint management office's signature → the reimbursement amount will be received.
Supervision System of New Rural Cooperative Medical System in Maogang District
1, the collection, management and use of the cooperative medical fund shall be separated, settled monthly, and the use of the fund shall be reported to the cooperative medical management committee on a regular basis. The district joint management office shall publicize the income and expenditure of cooperative medical care funds to the public once every quarter, and the township joint management office shall publicize the use of cooperative medical care funds in the current month, announce the list of reimbursement expenses and beneficiaries, and accept social supervision.
2. In order to ensure the safe and rational use of cooperative medical funds, several people's congresses, CPPCC, auditing, discipline inspection and village cadres should be employed as supervisors at district and town levels, and cooperative management offices at all levels are obliged to provide supervisors with the use of cooperative medical funds and take the initiative to accept the supervision of supervisors.
3, the town management office is responsible for the audit of hospitalization medical examination and treatment costs. The district joint management office regularly sends personnel to supervise and inspect, and if it is found that there are acts of favoritism and malpractice, it is necessary to investigate the responsibility of the parties for illegal reimbursement. Part of the illegal reimbursement shall be recovered by the manager, and the parties concerned shall be responsible for compensation if it cannot be recovered, and the whole region shall be informed at the same time. If it is found that the same person has been reimbursed for malpractice for personal gain for more than two times, he will be fined 2-3 times or treated as waiting for his post, in addition to compensation for the expenses of reimbursement for irregularities. District-level joint management office personnel have the above acts, and the town joint management office personnel are treated equally.
4, medical and health units must be based on the need for rational use of drugs, inspection and treatment, it is strictly prohibited to prescribe, excessive inspection, increase the burden on patients, or pursue the responsibility of the parties and leaders, and compensate patients for losses.