It is directly related to the rating of the designated medical institutions and whether the participants are satisfied. On the 16th, the Provincial People's Bureau issued the opinions on the implementation of the graded management of basic medical insurance designated medical institutions (tentative). Starting this year, medical institutions designated by all levels of human and social departments in the province have begun to implement dynamic hierarchical management.
There are four grades of designated medical institutions: AAA grade, AA grade, A grade and no grade. The main content of the assessment is the implementation of insurance policies and regulations and the implementation of the medical insurance service agreement, including basic management, outpatient management, hospital management, medical insurance information management, the degree of satisfaction of the participants.
The designated AAA, AA, and A-level designated medical institutions can receive the full-year and year-end return ratio of not less than 80%, respectively, and return the previous year's medical insurance service quality guarantee. The A-level designated medical institutions are no less than 60% at the end of the year. The proportion of returned medical insurance service quality guarantees for the previous year. For fixed-point medical institutions rated as no-grade, the previous year's medical insurance service quality deposits will not be honoured at the end of the year, and as the key inspection targets, the medical insurance agency will audit at least two monthly reports. Times.
Fixed-point medical institutions are graded and dynamically managed and rated once a year. Provincial People's Club Office said that in routine supervision, fixed-point medical institutions have been reported violations of medical insurance policy provisions or falsification, will be issued a deadline for rectification notice; serious violations of medical insurance policies, complaints or complaints of the people more bad , will reduce or cancel the level of fraudulent access to medical insurance funds for medical documents or other means of fraud, will be punished in accordance with relevant laws and regulations, cancel levels, until the cancellation of fixed-point. The designated medical institutions that have been degraded will not be able to return to their original levels within two years. Fixed-point medical institutions that have been cancelled will not be able to apply for a rating within two years.
There are four grades of designated medical institutions: AAA grade, AA grade, A grade and no grade. The main content of the assessment is the implementation of insurance policies and regulations and the implementation of the medical insurance service agreement, including basic management, outpatient management, hospital management, medical insurance information management, the degree of satisfaction of the participants.
The designated AAA, AA, and A-level designated medical institutions can receive the full-year and year-end return ratio of not less than 80%, respectively, and return the previous year's medical insurance service quality guarantee. The A-level designated medical institutions are no less than 60% at the end of the year. The proportion of returned medical insurance service quality guarantees for the previous year. For fixed-point medical institutions rated as no-grade, the previous year's medical insurance service quality deposits will not be honoured at the end of the year, and as the key inspection targets, the medical insurance agency will audit at least two monthly reports. Times.
Fixed-point medical institutions are graded and dynamically managed and rated once a year. Provincial People's Club Office said that in routine supervision, fixed-point medical institutions have been reported violations of medical insurance policy provisions or falsification, will be issued a deadline for rectification notice; serious violations of medical insurance policies, complaints or complaints of the people more bad , will reduce or cancel the level of fraudulent access to medical insurance funds for medical documents or other means of fraud, will be punished in accordance with relevant laws and regulations, cancel levels, until the cancellation of fixed-point. The designated medical institutions that have been degraded will not be able to return to their original levels within two years. Fixed-point medical institutions that have been cancelled will not be able to apply for a rating within two years.
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