Processing method of chronic disease qualification confirmation record in Yantai outpatient department

Processing method of chronic disease qualification confirmation record in Yantai outpatient department

Chronic diseases, also known as "non-communicable diseases" or "chronic diseases", do not specifically refer to a certain disease, but refer to a group of non-communicable diseases with long onset time, lack of clear evidence of etiology and incurability once they occur. The following is the way for me to share with you the qualification confirmation and filing of chronic diseases in Yantai outpatient department, hoping to help you.

Processing mode

1. The review of agreements that meet the bidding conditions shall be handled by designated medical institutions.

2. On-site handling: the business window of the medical insurance service hall in the insured place.

Directly under the municipal government: medical security service area on the second floor of Yantai Municipal Affairs Service Center, No.46 Hai Yin Road, Laishan.

Zhifu district: medical insurance service hall on the first floor, south, No.30 Huamao Street, Zhifu district.

Fushan District: Medical Insurance Service Hall on the second floor of Yongda Street 102 1 Fushan District, Yantai City.

Laishan: medical insurance service hall on the first floor of Jinmao Building, Yingchun Street, Laishan, Yantai 170.

Muping District: the lobby on the first floor of Muping District Government Affairs Service Center, No.368 Zhengyang Road, Muping District.

Haiyang City: No.91Arrival and Departure Center 1 1 Building, Jinan Road, Haiyang City

Laiyang City: Medical Insurance Service Hall on the second floor of No.7 Jinshui Road, Laiyang City

Qixia City: Medical Insurance Service Hall, No.335 Xiaguang Road, Qixia City

Penglai city: medical insurance service hall on the first floor of Penglai South Ring Road 136.

Long Island Experimental Zone: Social Security Service Hall at Paradise Avenue 10 1 Long Island.

Longkou City: Medical Insurance Service Hall on the first floor of No.320 Gangcheng Avenue, Longkou City.

Zhaoyuan City: Medical Insurance Service Hall on the second floor of Zhaoyuan Financial Building 128- 1.

Laizhou City: Medical Insurance Service Hall on the second floor, No.598 Weimin Street, Laizhou City

Development Zone: Social Security Service Hall, No.28 Zhujiang Road, Yantai Economic and Technological Development Zone

High-tech Zone: East Tower 1 F, Chuangye Building, No.69 Keji Avenue, Yantai High-tech Zone.

Treatment process

1. Procedures for designated medical institutions: The application materials provided by the insured in the initial examination of designated medical institutions shall be confirmed and put on record according to the access categories that meet the policy requirements, and the applicant shall be guided to choose the designated medical institutions that meet the requirements of the outpatient chronic disease agreement according to the principles of proximity, convenience and voluntariness, and signed by the applicant for confirmation. Belong to the instant completion of the disease, the record information will take effect immediately, and enjoy the treatment of chronic diseases in outpatient department according to the regulations. If it is a non-immediate disease, the filing information will be uploaded to the medical insurance agency in the place where the applicant is insured, and the medical insurance agency will implement the confirmation according to the disease access category, and the confirmation result will be notified to the applicant by the medical insurance agency in the place where the applicant is insured.

2. Medical insurance handling process: the medical insurance handling institution shall review the application materials provided by the insured, and confirm and record those that meet the policy requirements according to the disease access category.

3. In any of the following circumstances, it shall be subject to on-site audit by medical experts:

(1) The objectivity and authenticity of the medical records provided are in doubt;

(2) Incomplete medical records or inaccurate disease diagnosis;

(3) The patient's condition after systematic rehabilitation treatment may be inconsistent with the disease access standard stipulated by the outpatient department;

(4) Other circumstances requiring on-site audit by medical experts.

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