Fujian Medical Insurance Fund Supervision "Two Patient Demonstration" Work is excellent
Recently, Fujian Provincial Medical Insurance Fund Supervision Works Innovation Pilot Work, Work Work In May 2019, the National Medical Insurance Bureau issued the "Notice on Carrying the Demonstration of" Two Pilot Demonstrations ", Fujian Province, was selected for the national 2 medical insurance fund supervision methods. Innovative pilot provinces, Fuzhou City Selected Fund Supervision Credit System Construction Pilot City, Xiamen City was selected into medical insurance intelligent monitoring demonstration points.
In the past two years, 上海按摩微信群 the Provincial Medical Bureau and the Fuzhou Medical Insurance Bureau, the Xiamen Municipal Medical Insurance Bureau actively explored innovation, strive to improve the fund supervision system system, and continuously promote the innovation of regulatory methods in practice, and create a new pattern of medical insurance fund supervision. Fujian Medical Insurance Fund Supervision Method Innovation Pilot Work Fujian Medical Insurance Department, explored innovation, solid promotion, has achieved remarkable results in grid supervision, credit system and intelligent monitoring system construction, etc. Reform has accumulated rich experience. ● Constructing a credit system in the field of medical insurance will be fixed-point medical institutions, production and distribution enterprises, insurance personnel, medical service personnel, etc. All constituent elements involving medical insurance behaviors into medical protection credit management, formulate credit indicators, implement trust incentives, and discipline and disciplinary mechanisms. And determine the credit rating based on the deduction situation. ● Solidly promote the construction of intelligent monitoring system to develop real-time monitoring, video cloud monitoring, credit management, double random a disclosure, complaint report, medical care physician, and big data analysis, implementing administrative supervision, supervision and management, audit audit , Afterwards, monitoring, analytical end data analysis, intelligent supervision of prior reminders.
● Continuously strengthen the medical insurance on-site supervision to carry out the supervision advantage in the province’s 244 medical service stations, let the medical service station act as a "sentinel station" "alarm" in the medical department.
Implement the grid regulatory mechanism, grade the medical insurance system staff, corresponding medical institutions, clear supervision responsibilities, and improve the deterrent control of medical insurance. ● Introduced third party strength to participate in supervision special services for the purchase of medical insurance fund supervision inspections, and 2020 third parties all sent 28 batch of 829 people with respect to key inspections, flight inspections and clues verification.
● Constructing the linkage regulatory mechanism has established the medical insurance fund supervision method of the Provincial Medical Insurance Bureau, the Public Security Department, the Health Department, the Market Supervision Bureau, the Food and Drug Administration and other departments.
Since 2019, joint special actions such as investigation and punishment of medical insurance funds, cross-sectoral examination, "topic rectification" inside and outside the medical institutions have been launched.
Fuzhou City Credit System Construction Pilot Work Fuzhou City Printing and Distributing the "Fuzhou Medical Protection Social Classification Management Trial", carrying out the pilot work of credit system, innovation, practicality, and remarkable results. ● Implement credit main hierarchical classification management to customize the medical institution, fixed-point retail pharmacy, medical physician, fixed-point medical institution legal representative, entrants, etc., etc. Open "Introduction to the Combination of Pumgmentation, the daily differentiation supervision based on medical insurance credit is carried out.
● Incorporate medical credit evaluation into the citizen credit jasmine docking the Fuzhou city credit platform, and push the credit assessment results to Fuzhou people’s personal jasmine platform, and credit excellent citizens can enjoy 20% discount on urban bus subway, and the provident fund loan is raised. Joint incentive measures.
● Exploring the pilot work of medical insurance credit payment according to the insured credit information and medical credit rating, the third-party financial institution grants a certain amount of outpatient credit credit, used to pay the outpatient pre-contribution and personal account shortcomings Self-funded fees.
Xiamen medical insurance intelligent monitoring demonstration point work Xiamen City actively explores, boldly innovation, achieve significant progress in improving the system, optimization workflow, improvement system function, etc. system.
● The medical application of innovative people’s face recognition technology is the first to realize the full process "brush face" in medical insurance electronic credentials, and 上海魔都夜生活 innovate the double certification of the physician "brushing face + positioning". Application "Internet + Face Recognition" to achieve "mobile computer". ● Establish a medical institution’s video "cloud monitoring" system installed monitoring in the key premises of more than 300 medical institutions in the city, the full-time period, the whole scene, and innovative docking "Ping An Xiamen" construction system, real time adjustment Take the public safety platform video surveillance to create a "snow".
● Develop mobile audit systems to establish mobile medical supervision platform, add mobile phone report complaint function, real-time medical insurance inspection system, continuous online tracking of key monitoring agencies and insured people, and accurately blow. 上海闵行桑拿水磨会所 (The content is provided by the Fujian Medical Insurance Bureau) (Editor: Chen Chuchu, Zhang Zijian) Sharing Let more people see the client download.