Today's Yongzhou News (correspondent Ouyang Qing, Luo Huiping, Zhou Min).In order to further standardize the overall use of outpatient clinics for employees of designated medical institutions, and maintain the safety of medical insurance and the legitimate rights and interests of the majority of insured employees, recently, the Ningyuan County Medical Security Bureau sent business backbones as instructors to take turns to coordinate the designated pharmacies of medical insurance outpatient clinics for on-site duty and supervision.
There is a high degree of leadership attention. The Party Group of Ningyuan County Medical Security Bureau has held special meetings for many times to study and deploy the overall work of outpatient clinics, and has set up a working group with the director as the team leader, the party group members as the deputy team leader, and the heads of the medical service unit and the first supervision unit as members. Further refine the objectives and tasks, clarify the work responsibilities, and build a working mechanism for the "top leader" to personally grasp the work, the leader in charge to directly grasp it, and the responsible unit to grasp it specifically. The bureau organized a coordination meeting for the coordination of staff outpatient co-ordination of designated pharmacies, and clearly required all designated medical institutions to carry out diagnosis and treatment and audit in strict accordance with the regulations, standardize the use of medical insurance, and strictly prohibit the behavior of taking outpatient co-ordination. The person in charge of the medical insurance bureau led a team to some designated medical institutions with more suspicious data and rapid cost growth for supervision and inspection.
Regulatory enforcement is strong. Take irregular on-site supervision, mainly through access to electronic prescriptions, outpatient medical records, verification of cost details and "purchase, sale and inventory", comparison and settlement lists, etc., to verify whether there are Internet medical records are not standardized, there are no physical medical institutions medical records, medication and diagnosis and treatment are inconsistent, outpatient co-ordination of children's drugs, false medical treatment, false prescriptions, inflated expenses, collusion of drugs, illegal charges and other violations, and the suspicious reimbursement records found in the inspection are revisited, without missing any suspicious clues;All designated medical institutions are required to establish a ledger to ensure that there are records of medical treatment, prescriptions for medication, and receipts for chargesAdhere to "zero tolerance" for problems that are verified to be true, and resolutely find them together, handle them together, and deal with them together, so as to form a strong deterrent.
Optimize the service with temperature. The medical insurance instructor patiently and meticulously preached and interpreted the latest medical insurance policies to the masses who came to buy drugs, focusing on the interpretation of policies such as outpatient treatment, outpatient treatment of chronic diseases, outpatient mutual aid for employees and outpatient co-ordinationCorrect some erroneous rumors that "outpatient co-ordination is not used, and the balance will be cleared at the end of the year", take the initiative to empathize, do practical things for the masses with heart and affection to solve problems, constantly innovate service methods, and strive to be a good "escort" for the health of the people;Increase publicity and guidance, popularize policies, and teach the masses to use the "Hunan Medical Insurance" app and pay attention to the "Ningyuan Medical Insurance Affairs" WeChat to improve the awareness rate and satisfaction of the masses' medical insurance policies.
The results of the work are in-depth. Increase the frequency and intensity of inspections, start from safeguarding the rights and interests of insured employees in medical insurance, implement precise policies, and systematically govern to ensure the safe and stable operation of outpatient co-ordination, and effectively enhance the people's sense of gain, happiness and securityCheck the risks of employee medical insurance outpatient co-ordination one by one to find out the hidden dangers that affect the safety of the employeesIn response to the problems found in the inspection, clarify the regulatory ideas, take targeted regulatory measures, strive to create a good atmosphere for maintaining the safety of medical insurance, and make every effort to be the "gatekeeper" of medical insurance.