How to handle the slow door, how to handle the slow door

The specific process of door slow handling is as follows:

1.The insured person shall hold the medical insurance card and valid identity certificate to the designated medical institution with the qualification of designated chronic disease diagnosis to receive the "XX City Medical Insurance Designated Chronic Disease Diagnosis Certificate".

2.Under the leadership of the chief (deputy chief) physician of the designated medical institution, the full-time staff of the medical (medical insurance) department or the designated outpatient physician shall carry out the identification of chronic diseases.

3.If it is found to be qualified, the physician at or above the deputy director level or the department director shall sign the review opinion, and the medical (medical insurance) department of the designated medical institution shall issue the corresponding special medical record for chronic disease outpatient clinics.

4.After the issuance of special medical records, patients can be treated in the outpatient clinic of a medical institution or in the designated physician's office with their medical insurance card and special medical records, and enjoy the treatment of chronic diseases in the outpatient clinic of XX City Medical Insurance.

It should be noted that in different cities and different types of medical insurance, the specific slow processing process may be different. Therefore, it is recommended that you consult the relevant local departments or call the local ** for consultation according to the local medical insurance policy. At the same time, the application materials for handling the slow treatment include ID cards, social security cards, relevant inspection reports, etc., and the specific requirements also need to be consulted with the relevant local departments.

Handling process: 1. The insured person shall go to a qualified designated institution for medical treatment with a medical insurance card and ID card, and establish a special outpatient medical record for medical insurance.

2. After the diagnosis is confirmed, the attending doctor of the designated institution fills in the "Certificate of Diagnosis of Chronic Diseases Designated by Municipal Medical Insurance".

3. Signed by the deputy senior physician or department director of the hospital. Go to the medical (or medical insurance) department for review and sealing, and apply for registration in the medical insurance information system office.

4. Prescribe drugs at the designated institutions and settle through the medical insurance information system. Approved by the medical insurance information system.

5. The designated institution will submit the relevant information after review to the insured, and use the special outpatient medical record as one of the vouchers for enjoying the corresponding treatment.

Chronic disease is an outpatient chronic disease. Outpatient chronic diseases are not paid for by the health insurance card every month. Outpatient chronic diseases refer to patients with large diseases who need to take drugs for a long time, and the medical insurance center implements outpatient subsidies for such patients, and patients with large diseases can apply to the medical insurance center for outpatient chronic diseases as long as they meet the conditions, and the patients can be directly reimbursed in the hospital after each purchase of daily drugs.

Slow gating includes 42 diseases, divided into three categories. Category I: Stage II, III hypertension.

Angina pectoris, myocardial infarction. Rheumatic heart disease. Dilated cardiomyopathy.

Diabetes type 1, type 2. Sequelae of cerebral infarction, sequelae of cerebral hemorrhage, and sequelae of subarachnoid hemorrhage. Parkinson's disease, Parkinson's disease.

Epilepsy, etc. Category II: Chronic hepatitis B, hepatitis D, etc.

The third category: systemic lupus erythematosus, etc.

The reimbursement ratio of outpatient chronic diseases varies from place to place, and the general outpatient chronic reimbursement has a minimum payment standard of 500-1000 yuan, and the reimbursement ratio of the part above the minimum payment standard ranges from 60% to 100%, and the annual reimbursement amount is limited, which is subject to the local social security department.

Slow outpatient disease refers to outpatient chronic disease, and the process is as follows:

1.Go to the window of the lobby of the designated hospital for medical insurance**.

2.Go to the designated hospital for medical treatment and submit the outpatient chronic disease application form filled in by the individual.

3.After the hospital confirms the chronic disease, the completed application form is certified and recorded, and you can receive the chronic outpatient diagnosis.

Legal analysis: 1. Hospital visits.

2. Apply for "slow door" registration.

3. Review by the hospital medical insurance office.

4. Handle the registration of "slow door".

5. Enjoy the settlement by swiping the card in the hospital.

6. Medical insurance "slow door" treatment.

Legal basis: Social Insurance Law of the People's Republic of China Article 31 Social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and drug business units to standardize medical services. Medical institutions shall provide reasonable and necessary medical services to insured persons.

Taking ** county in Anhui Province as an example, the time for handling chronic disease certificates is in May each year (May 1 - May 31), and those who meet the requirements after handling the posture will apply for chronic disease certificates at the end of the third quarter (June). 1. Materials to be provided for the declaration of outpatient chronic diseases: 1. A copy of the inpatient medical record of a public medical institution of the second level or above in the past two years.

2. A copy of the social security card or cooperative medical certificate 3. A copy of the ID card. 2. Application and approval procedures: Outpatient chronic diseases are subject to a one-year declaration system.

Insured urban and rural residents should submit application materials to the county urban and rural residents' medical insurance center in May each year (May 1 - May 31). For the declaration of the insured personnel, the county urban and rural residents medical insurance center should organize experts to enter the service for identification in accordance with the requirements of the "Xinyang Basic Medical Insurance Outpatient Chronic Disease Identification Standards", and the chronic disease identification work will be completed at the end of the third quarter of the year. If the appraisal is passed, the county urban and rural residents' medical insurance center shall handle the outpatient chronic disease medical treatment.

If the appraisal fails, explain the reasons to the declarant. Extended information: The time for the processing of chronic disease certificates is from May 10 to May 25 and October 10 to October 25 every year, among which, the declaration time for the three major diseases of malignant tumors, anti-rejection after organ transplantation, and kidney failure dialysis outpatient clinic** remains unchanged, which is still in the early part of each month, and the identification and issuance of certificates are organized and issued once a quarter.

You must bring the following information: a copy of the inpatient medical record, a social security card and a 2-inch color photo. Insured persons who have handled two diseases cannot change the disease in May, but can change it in October; Add a disease.

Legal analysis: Generally, chronic disease certificates are handled every six months or quarterly, depending on how the local regulations are made, and specific problems should be analyzed.

Legal basis: Social Insurance Law of the People's Republic of China Article 4 Employers and individuals within the territory of the People's Republic of China who pay social insurance premiums in accordance with the law have the right to inquire about payment records and personal rights and interests records, and request social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise their own units' contributions for them.