Diagnosis and treatment items of instruments, equipment and medical materials: 1, which is necessary for clinical diagnosis and treatment, safe and effective, and expensive.
Use appropriate diagnosis and treatment programs; 2, by the price department to develop the diagnosis and treatment project fees; 3, by the designated medical machine
It is a diagnosis and treatment project within the scope of medical services provided by the insured. This definition includes the following aspects.
Han:
First, clear the scope of diagnosis and treatment projects. In clinical medical services, services related to diagnosis and treatment are very important.
Many, but not all, medical services are medical treatment programs. According to this definition, the first diagnosis and treatment refers to
Medical technical services, such as medical expenses, operation expenses, anesthesia expenses, laboratory expenses, etc. Reflect
Nursing expenses and injection expenses of nursing staff services, but excluding some non-medical technical services, such as nursing workers and catering.
Waiting for life service. Two refers to the use of medical instruments, equipment and medical materials for diagnosis and treatment projects, such as
Inspection of related laboratory instruments, diagnostic equipment such as B-ultrasound and CT, infusion, catheters, artificial organs and other medical materials.
Materials, etc. , excluding some instruments, equipment and materials that are not used for diagnosis and treatment, which do not belong to the scope of diagnosis and treatment projects, such as
Instruments and equipment managed by the hospital, service facilities to improve the living environment, etc.
Two, to determine the basic medical insurance diagnosis and treatment projects should meet three conditions: first, clinical necessity, safety and effectiveness,
Appropriate expenses for diagnosis and treatment projects. Clinical necessity is the necessity of clinical treatment of diseases, which is relative to non-disease treatment.
Beauty and other diagnosis and treatment projects, and compare the main diagnosis and treatment methods of disease treatment with auxiliary diagnosis and treatment methods such as music therapy.
Wait a minute. Safe and effective refers to mature projects that have been widely recognized after long-term clinical use, compared with research.
Some diagnosis and treatment measures with uncertain staging and curative effect, such as heart, lung and brain transplantation. The right cost is that it must be based on
The payment ability of this medical insurance fund is appropriate. In the diagnosis and treatment projects with the same diagnosis and treatment effect, the price is reasonable.
Diagnostic and therapeutic programs. Second, the price department has formulated the charging standard for diagnosis and treatment projects. This is based on diagnosis and treatment project management.
It is mainly put forward by the price department to determine the current situation of charging prices. There are many kinds of diagnosis and treatment projects and water for economic development.
The diagnosis and treatment projects that meet the first condition are not in provinces (autonomous regions and municipalities) with different medical technology levels.
Yes, according to the charging standard of the price department, the diagnosis and treatment items of basic medical insurance can be set in one first.
In a clear range. The third is the diagnosis and treatment projects within the scope of medical services provided by designated medical institutions for the insured.
Eyes. The basic medical insurance shall be managed by designated medical institutions, and only designated medical services determined by social insurance agencies shall be provided.
All kinds of diagnosis and treatment projects provided by institutions can only be included in the scope of payment of basic medical insurance funds. Non-designated medical devices
The basic medical insurance fund will not pay for the diagnosis and treatment projects provided by this institution. This condition is to co-ordinate the funds in the region.
The condition of timely payment is also a means to rationally plan health resources from the perspective of medical insurance.