Etcepool pool
This is the share of ore pool in the past three months:
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but in fact, it's of little use. It's just the difference between 100 yuan and 100.5 yuan. If your calculation power is really big, it may be much worse, but if it's ordinary, it's not much different. It is more important to choose one with low or free service charge
This is the pool share in the past three months:
After the outpatient fee list is paid, a small ticket will be printed in the payment window
About visiting hospital: the hospital must go to the hospital within the scope of our insurance coverage to get the claimthe hospitals supported by traditional medical insurance have the general departments of the hospitals of grade 2 or above
the middle-end medical service can go to the General Department of level 2 or above hospitals, and some plans can also go to the VIP ward, special needs department and International Department of level 2 or above hospitals
for high-end medical services, we can go to the general department, VIP ward, special needs department and International Department of level 2 and above hospitals; General private hospital; Expensive private hospitals, etc
2. On the scope of medication: in terms of medication, it should be noted that it must be "reasonable and necessary" prescription drugs. Generally speaking, it can not be "reasonable and necessary" beauty, health care, infertility, weight loss, etc., unless the protection responsibility is clearly stated in the coverage
3. In terms of diagnosis and treatment, attention should be paid to 1) make the first diagnosis as much as possible
2) it must be a "reasonable and necessary" diagnosis and treatment item. Generally speaking, it can not be "reasonable and necessary" beauty, health care, infertility, weight loss, etc., unless the protection responsibility is clearly stated in the coverage
extended data
classification of outpatient service
according to the patient's condition, urgency and health status, it can be divided into general outpatient service, health outpatient service and emergency outpatient service
1. The patients who come to see a doctor consciously or feel that they have abnormal physical or mental performance can be checked and treated according to the doctor's arrangement ring the outpatient time
The patients in the health care clinic were conscious of their health, and they were given preventive examination, health consultation, disease census, premarital examination, vaccination, perinatal health care, cancer prevention census, infant health clinic, etc3, emergency outpatient service
the objects of emergency outpatient service are all patients who are in urgent condition, in crisis, need timely diagnosis and treatment or rapid rescue, so we must seize every minute. The emergency room should be open 24 hours a day
settlement proceres for inpatients and outpatients with special diseases:
designated medical institutions shall report the expense settlement sheet, inpatient settlement sheet and relevant information of discharged patients in the previous month to the medical insurance agency before the 10th day of each month, which will be used as the basis for monthly budget and year-end final accounts after being reviewed by the medical insurance agency
medical insurance agencies pre allocate the overall expenses of hospitalization and outpatient treatment of special diseases in the previous month
the insured with special diseases should go to a designated medical institution designated by the labor and social security department for medical treatment and purchase, and the medical expenses incurred should be directly recorded and settled immediately
emergency settlement procere: the medical expenses incurred by the insured who are hospitalized in non designated medical institutions and other medical institutions in the city e to emergency rescue shall be paid in advance by the indivial or unit. After the end of emergency rescue, the reimbursement proceres shall be handled by the medical insurance agency according to the regulations with the hospital emergency medical records, examination, laboratory report, invoice and detailed medical charge list
settlement procere for off-site resettlers:
the unit where the off-site resettlers are located shall designate 1-2 designated medical institutions for them and report them to the medical insurance agency for record
the medical expenses incurred by the staff in different places who are ill in the designated medical institutions of their residence shall be paid by themselves or their units in advance. After the treatment, their units shall go to the social medical insurance agency for settlement with the medical certificates and medical records of the insured, valid expense bills, plicate prescriptions, hospitalization expenses list, etc. on the specified date.