The latest notice of Hebei Medical Insurance Bureau

On September 29, the Provincial Medical Insurance Bureau issued the latest notice details as follows

The notice of Hebei Medical Security Bureau on optimizing and upgrading the functional function of the whole province's slow special disease declaration review system

The medical security bureau of various cities (including Dingzhou, Xinji City), the Public Service Bureau of the Xiong'an New District Management Committee, the North China Oilfield Medical Security Center, the provincial medical security agency:

In order to further improve the efficiency and convenience of slow special diseases in the province, on the basis of fully investigating and extensive solicitation of opinions, the Provincial Medical Security Bureau conducts the review system of slow special disease application (hereinafter referred to as "system") of the medical insurance clinic of Hebei Province (hereinafter referred to as "system") After optimizing and upgrading, some of the new operating functions are added, and the relevant matters are notified as follows.

1. Easy to declare operations

(1) The application end increases the withdrawal function. The insured persons declare the disease on the application side. If the preliminary examination physician did not accept it, the applicant was submitted and found that the error could be revoked.

(2) Added online supplementary data functions. For those who have made supplementary information due to incomplete data, the applicants can supplement the information online and submit it. The supplementary information and the original upload information are automatically stored in the system.

(3) Add automatic saving function during uploading information. In the process of uploading the information, if you are not attracting the program or interrupted upload, the system will automatically save the transmitted information. The applicants can choose to continue uploading at the declaration entrance. The information has been passed on without repeated operation.

(4) Set the ID card to the required item. In order to ensure the efficiency of the insured person's declaration and reduce the phenomenon of the impact of the impact of the influence of the identity card, the system uploads the function of the evidence of the evidence into two items, namely: upload the front and back photos of the ID card and upload other evidence materials, and upload the ID card to the ID card Set up to compulsory items.

(5) Add prompts on the application side. After submission of slow special disease information (or supplementary materials required by the doctor), the insured person can see a warm reminder: after you submit the application information (or the required supplementary material) online, please go to the medical institution on the spot within 30 days to check (special specialty (special specialty Except for personnel), if the overdue has not been verified on the spot, the system is deemed to have given up automatically. When the applicant query the review progress, the prompt can also be seen.

(6) Shorten the time interval of the re -declaration. If the review is not passed due to the incompatible information, the original review can be re -approved to be re -approved to be re -declared the next day after a month.

2. The review is rigorous and efficient

(1) Added a "review and withdrawal" function in the initial and review session of the physician. The preliminary review and review physician identified the "review and revocation" function within 10 minutes. After the physician misunderstood the conclusion of the review, click "Return" in 10 minutes to revoke his opinion. After the revocation, you can re -review.

(2) The automatic return function is implemented for the acceptance information that has not been verified on -site. For those who have not arrived at the scene after 30 days, or those who need to be supplemented but not supplemented, the system sets its declaration information to fail. Medical institutions can inquire about the historical failure information of the unit at any time, and the doctor can also query the failure information of the applicant's ID number, so that medical institutions and doctors explain to the applicants.

(3) Refined classification of the declared information. The medical insurance side, the hospital, and the doctor's side report the "to be reviewed" module in the "to be reviewed" into two query modules: "to be reviewed" and "to be reviewed", which is convenient for refined management and work supervision to avoid the risk of leakage review.

3. Scientific standards for management

(1) Strengthen the statistical query function. The functions of the system can be added according to the time period, review of medical institutions, and medical inquiries of statistical slow special disease identification personnel. The medical insurance agency can conduct statistical analysis and accurate monitoring at any time according to the authority. The above screening data can be exported with one click.

(2) Give municipal -level agencies inquiring authority. In order to meet the needs of regulatory review and determination, the function of querying the statistics of the municipal agencies can query the function of the evaluation and identification of any county, district or medical institutions in this coordinated area, that is, the municipal -level agencies can follow the county (district), medical institutions, and medical institutions, and Conditions such as diseases and other conditions The number of applicants, the number of people, the list, etc. within a certain period of time, and can accurately inquire about the identification information of the outpatient clinic of the insured person in this coordinated area according to the ID number (including uploading information and identifying the doctor's opinion).

(3) Added the module of the validity period of the disease. First, next to the "Disease Idential Standard Maintenance" module of the medical insurance agency, a module of the validity period of the disease is added. Essence Participants reported that they would enjoy the treatment within the validity period after successful the disease. The second is to add a system to automatically calculate the function of slow special disease treatment (accurate to day). After the expiration, the system will automatically stop its slow special disease treatment. Third, a long -term reminder of the "Historical Inquiry" module at the Slow Special Disease Declaration interface: "Your ×× disease has been determined to be successful, and it will fail until × year × month × day."

(4) Transfer of the transitional area to the original identification of the type of disease automatically invalid. After the insured person handled the inter -planning zone transfer and continued medical insurance relationship, the previous identification of slow special disease information in the system was automatically invalid (the system retains failure information), which can be re -declared in the transfer, and is not disturbed by previous identification information.

Fourth, functional applications to the ground are effective

(1) Strengthen publicity and guidance. The medical insurance departments of each overall planning area shall promptly issue relevant notices, and the participating units, review medical institutions and medical insurance agencies shall do a good job of propaganda and guidance of new functions, so that the participating people will be familiar with the application process, and the evaluation doctors will improve the efficiency of review. The staff are proficient in the system function. (2) Do a good job of application training. The medical insurance departments of each co -ordination area shall actively promote the application of new functional applications, strengthen the guidance of the training of personnel training and medical institution's outpatient clinics, and effectively give full play to the role of the people and the people.

(3) Monitoring operation. The medical insurance departments of each coordinating area should do a good job of operating monitoring of the new functional application of the system, pay attention to the relevant demands of the masses, solve the problems encountered in actual work in a timely manner, and effectively prevent and resolve the occurrence of public opinion.

Hebei Provincial Medical Security Bureau

September 26, 2022

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