Where to handle the reimbursement for chronic disease treatment in Changzhou Wujin outpatient department?

Where to handle the reimbursement for chronic disease treatment in Changzhou Wujin outpatient department?

Medicaid, also known as medical care, refers to the medical services for diseases that the insured can enjoy. The types of medical services provided by sickness insurance in different countries are different, but they generally include the treatment of general doctors, certain hospitalization and necessary drug supply. Below I sorted out the detailed information of where to apply for reimbursement for chronic disease treatment in Changzhou Wujin outpatient department, hoping to help you!

1. Where can I apply for reimbursement of chronic disease treatment in Changzhou Wujin Clinic?

The all-round processing window of the District Social Security Center is No.518, Wu Nan Road, Wujin District, which is responsible for applying for physical examination and identification of various diseases; Chronic hepatitis (moderate to severe) can be applied in the Medical Insurance Office of Changzhou Third People's Hospital; The inspection-free business is only accepted at the general handling window of the district social security center.

Second, the acceptance conditions:

Insured persons who suffer from hypertension (stage II and III), diabetes, malignant tumor, chronic hepatitis (moderate or severe), systemic lupus erythematosus and Parkinson's disease, meet the requirements of "Hospitalization Conditions for Outpatients with Chronic Disease Drug Subsidy in Wujin District of Changzhou City" and participate in the basic medical insurance for urban employees (except those who participate in hospitalization medical insurance).

Three, Changzhou Wujin outpatient chronic disease treatment reimbursement application process

The clerk should bring a valid ID card and social security card, and every time he applies for illness, he needs a recent bareheaded photo. For the medical history data of more than half a year, materials such as discharge summary and auxiliary examination report can be provided in the specialized treatment of hospitals above the second level, and medical examination and identification of all diseases can be applied in the all-round handling window of social security centers, towns, development zones and street people's social departments in this district; After the approval, the social security staff will inform the results by SMS after passing the medical examination or exemption.

Four. Acceptable materials

The clerk should carry a valid ID card and social security card, and each application for illness requires one-inch recent bareheaded photo and the following medical history data.

1, materials required for applying for special disease identification:

(1) Malignant tumor: discharge summary, physical examination report and imaging diagnosis report must be provided.

(2) Hypertension (stage II-III): Relevant information for more than half a year is required. If there is hospitalization, the discharge summary shall prevail; If there is no hospitalization, the true and effective original outpatient medical records and medication history records shall prevail. People suffering from cerebral infarction, cerebral hemorrhage, myocardial infarction, congestive heart failure, etc. , should provide discharge summary or related imaging diagnosis data.

(3) Diabetes: It needs more than half a year's relevant information. If there is hospitalization, the discharge summary shall prevail (according to the diagnosis, medical history and taking hypoglycemic drugs); If there is no hospitalization, the true and effective original outpatient medical records, medication history records and two venous blood sugar test reports of different dates shall prevail. (Three blood glucose values for clinical diagnosis of diabetes: fasting ≥7.0mmol/L, postprandial ≥1.1mmol/L, random ≥ 1 1 mmol/L).

(4) Systemic lupus erythematosus and Parkinson's syndrome: authentic and effective original medical history data must be provided. In case of hospitalization, the discharge summary shall prevail.

(5) Chronic hepatitis (moderate to severe): outpatient medical records, laboratory tests or discharge summaries for more than half a year.

2. Materials required for inspection exemption:

If the data meet the standard of exemption for specific diseases in Wujin District after examination, they can be exempted from physical examination and directly enter the examination procedure, as follows:

(1) Malignant tumor. Can provide a clear diagnosis of discharge summary, pathological report or auxiliary examination report;

(2) Stage Ⅲ hypertension. 1, hypertension complicated with cerebral infarction and cerebral hemorrhage; 2. Hypertension complicated with myocardial infarction, congestive heart failure, heart bypass surgery, coronary heart disease stent implantation history; 3. Hypertension with renal failure (serum creatinine concentration >; 177mmol/L or 2.0mg/dl); 4. Hypertension with dissecting aneurysm and symptomatic arterial occlusive disease. With one or more of 1, 2, 3 and 4. Can provide the discharge summary and auxiliary inspection report of specialized treatment in hospitals above the second level;

(3) diabetes. Can provide the discharge summary and auxiliary inspection report of specialized treatment in hospitals above the second level;

(4) Systemic lupus erythematosus. Can provide the discharge summary and auxiliary inspection report of specialized treatment in hospitals above the second level;

(5) Parkinson's syndrome. Can provide the discharge summary and auxiliary inspection report of specialized treatment in hospitals above the second level;

(6) over 75 years old. It can provide real, effective and definite medical history data and auxiliary examination reports, and confirm that patients with hypertension, diabetes, malignant tumor, chronic hepatitis (moderate to severe), systemic lupus erythematosus and Parkinson's syndrome need long-term drug treatment.

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