(2) Planning and Finance Unit (Treatment and Protection Unit). Organize the formulation of medical security work plans and promote the reform of medical insurance payment methods. Draw up the service agreement of designated medical institutions and the payment management of medical insurance funds. Formulate policies on financing and treatment of medical security, and coordinate the treatment standards of urban and rural medical security. Make overall plans to promote the construction of a multi-level medical security system. Responsible for the identification and certificate handling of municipal major diseases and chronic (special) diseases, and responsible for the suggestions, consultations and explanations of medical insurance policies. To undertake the budget and final accounts, finance and asset management of the organs and subordinate units; According to the management authority, undertake the pricing and implementation of drugs; Cooperate with provinces and cities to carry out reasonable determination and dynamic adjustment mechanism of medical service price for medical insurance payment, and establish price information monitoring and information release system. Responsible for reviewing the compensation data reported by designated medical institutions on the spot, and organizing expert review meetings to review and identify unreasonable diagnosis and treatment behaviors; Responsible for the statistical analysis of average hospitalization expenses, average daily expenses, actual proportion of compensation drugs, drugs outside the catalogue, positive rate of examination and other data; Responsible for the audit of special diagnosis and treatment projects and special materials; Responsible for the business training and guidance of designated medical institutions; According to the reimbursement compensation policy, accept the medical reimbursement compensation for the insured of medical institutions in different places; Responsible for handling referral business. To implement the policies and standards of national, provincial and municipal medical maternity insurance and supplementary insurance for urban workers, and implement the policies of raising, paying, managing and operating provincial medical maternity insurance funds; Implement the basic principles and policies of the state on medical maternity insurance, and undertake the comprehensive statistical summary and reporting of medical maternity insurance in the whole region; In accordance with the scope of medical maternity insurance as a whole as stipulated by the state and the province, register medical maternity insurance for regional units and flexible employees as a whole, and collect insurance premiums; To undertake the verification and payment of medical and maternity insurance benefits for employees and retirees in the whole region. Responsible for the certification and management of hospitals and pharmacies. Responsible for accepting the direct settlement of medical maternity insurance in different places and the transfer and connection of medical insurance relationship. Responsible for the formulation, organization and implementation of urban and rural medical assistance system and the examination and approval management of urban and rural medical assistance within their respective administrative areas; Responsible for the declaration and handling of non-"one-stop" on-site direct settlement of medical assistance subsidy funds. Responsible for the normal operation, operation, maintenance, upgrade, training and business guidance of the medical insurance system; Responsible for the information maintenance of medical and maternity insurance agencies in the whole region; Using the function of information system, responsible for analyzing and detecting the income and expenditure of funds together with financial personnel and auditors; Responsible for the dynamic supervision of the service behavior and service quality of designated medical institutions and the assistance and compensation of insured persons to prevent fund risks; Responsible for the information maintenance of the insured in the whole region; To be responsible for arranging, filing and keeping related materials such as reimbursement for medical treatment outside the district, handling chronic (special) diseases (serious illness at the municipal level) and referral (transfer); Responsible for the issuance and review of insurance premium bills. (Planning Finance Unit (Treatment Protection Unit) Tel: 0857-83 15677)
(3) inspection unit. Undertake the work related to legal counsel. Undertake the legality review of normative documents, and undertake administrative litigation and administrative compensation. Undertake the work related to the capacity building of scientific and technological innovation. Implement the supervision and management measures and internal control system of medical insurance fund, establish and improve the safety prevention and control mechanism of medical insurance fund, establish and improve the credit evaluation system and information disclosure system of medical insurance; Supervise and manage medical services and medical expenses included in the scope of medical insurance payment, standardize medical insurance handling business, and investigate and deal with illegal acts in the field of medical insurance according to law. To be responsible for formulating the work plan of medical insurance fund inspection; Organize inspection, guidance, supervision and management of medical security work in the whole region; Responsible for the supervision of designated medical institutions; Responsible for providing consulting services for designated medical institutions and insured persons, and accepting relevant complaints, reports and letters and visits; Responsible for the investigation and handling of special circumstances such as trauma. (Tel: 0857-83004 19)
Director of Qixingguan District Medical Security Bureau: Peng
Qixingguan District Medical Security Bureau Tel: 0857-82866 13
Qixingguan Medical Security Bureau Address: Qixingguan Medical Security Bureau 10 Floor, No.82 Boxue Road, Ma Yuan Sub-district Office, Qixingguan District, Bijie City, Guizhou Province
Medical insurance window of government affairs hall of medical security bureau in Qixingguan District Address:No. Boxue Road 1, comprehensive acceptance window of natural person comprehensive service area on the third floor of government affairs service center of Qixingguan District, Bijie City, Guizhou Province.
The service telephone number of medical insurance window in the government affairs hall of Qixingguan District Medical Security Bureau is 0857-823 1589.
Letter: Ma Yuan Sub-district Office, Qixingguan District, Bijie City, Guizhou Province, No.82 Boxue Road 10 Floor.
Postal code: 55 1700
E-mail: qxgqylbzj @163.com.
Office hours: 8: 30am-65438+02: 00pm-14: 00pm-17: 30pm on national legal working days.