- Date:2013-08-05
- Click:190Times
Since March 20, 2012, our hospital has been carrying out the “first diagnosis and treatment, after settlement”, during which one third of the local medical insurance and agricultural cooperative patients have been benefited, which to a certain extent reduces their financial burden, and is highly praised by the society. In order to further enhance the connotation of the hospital construction, focusing on reflecting the “benefiting the people to run the hospital” idea, our hospital on July 20, 2013 on the medical insurance and the new rural cooperative inpatient hospitalization fully implement the implementation of the “first diagnosis and treatment, after the settlement” service mode. Characterized by the following aspects.
I. Reflecting the hospital's policy of benefiting the public
2013 is our hospital connotation construction year, with the “three hospital level assessment” as an opportunity to vigorously improve the hospital's comprehensive service level, is the work of the guidelines, and “first diagnosis and treatment, after the settlement” as one of the substantive content, the hospital leadership attaches great importance to. “First diagnosis and treatment, after settlement” to health insurance and the new rural cooperative as the basis, closely around the convenience of the people, benefit the people, benefit the people's goal, optimize the consultation service process, to explore the new model of medical service charges, to ensure that patients in the first time to get timely treatment, and effectively alleviate the masses of ”difficult to see a doctor, expensive to see a doctor! “This is also a way for the hospital to realize the goal of quality and efficiency. This is also a way for hospitals to realize the connotative qualities of quality, efficiency, economy and safety.
II. Expanded scope of implementation
Summarizing more than a year of operational experience, our hospital has expanded the scope of implementation of “first diagnosis and treatment, and then settlement”: all the local agricultural cooperative, medical insurance, urban residents and Linxi, Qinghe, Xazin medical insurance patients hospitalized in our hospital can be implemented in our hospital “first diagnosis and treatment, and then settlement” service. For For the “three no” patients and patients in need of emergency treatment such as acute and critical illnesses, our hospital is still the implementation of the hospital's general duty “green channel” system to ensure the implementation of the policy.
Simplified service process
The Medical Department, Medical Insurance Department, Hospitalization Department and Information Department of the hospital have improved the mode of “diagnosis and treatment before settlement” based on the original mode of operation and after full demonstration. The procedure is as follows: Any “insured patient” who meets the conditions of “diagnosis and treatment before settlement” stipulated by the hospital:
→Go to the hospitalization office with your ID card to go through the registration procedure.
→ Go to the medical insurance office with the agricultural cooperative card (or medical certificate) and ID card (or hukou book) to check the identity and make copies of the documents.
→After entering into the medical insurance and agricultural cooperative network, you will enter the process of “diagnosis and treatment first, and then settle the bill”.
The above simplified procedure benefits from multi-departmental coordination and improvement, reducing the number of patients going back and forth between the hospitalization office, medical insurance office, ward, reducing the number of trips, reducing the trouble.
Fourth, the realization of the real benefit to the people
Benefiting the people to put things into practice, both to do to benefit the people and avoid risk is the difficulty of this improvement. The hospital leadership attaches great importance to the collaboration of many departments, is an important guarantee to achieve this. The program of measures for the benefit of the people is as follows:
All the patients who have been approved to meet the conditions of “first diagnosis and treatment, then settlement” can not pay the deposit when they are admitted to the hospital, the hospital first prepaid 2000 yuan “advance payment” (set by the program). When the treatment costs close to 2,000 yuan, the system will automatically lock the billing window and the nurse workstation cannot keep score. The ward staff will call for payment of the deductible amount.
Each time a patient pays the bill, the system will automatically configure the prepayment for the patient in proportion to the patient, and the medical insurance patients will be configured at 150%, i.e., the self-payment of 2,000 yuan can consume 5,000 yuan, and the other 3,000 yuan will be prepaid by the hospital;
New rural cooperative and urban residents patients at 50% allocation, that is, self-payment of 2,000 yuan can consume 3,000 yuan and another 1,000 yuan prepaid by the hospital.
When discharged from the hospital to take the deposit paid together with the settlement, the more the less the compensation.
If the patient is admitted to the hospital on a voluntary deposit, the same will enjoy the above proportion of the configuration of the prepaid.
The full implementation of “first diagnosis and treatment, after settlement” fully reflects the hospital's “patient-centered” service determination and strength, which is a concrete demonstration of the hospital's public welfare, but also the well-being of the people in and around Linqing.