Address: No.333 Changjiang Middle Road, Hefei
Collection and payment plan group telephone: 2624239, 2622833.
I. Institutional responsibilities
1. Responsible for confirming that medical institutions and retail pharmacies with designated qualifications are designated medical institutions and retail pharmacies for provincial-level insured persons;
2, specifically responsible for the provincial insured units to declare data audit, collection plan formulation and the insured medical insurance card, card issuance and management;
3 responsible for signing service agreements with designated medical institutions and retail pharmacies;
4. Settle medical expenses with them according to the agreement and relevant policies and regulations of medical insurance;
5 at the same time, check or spot check the medical behavior and related information of designated medical institutions and retail pharmacies.
Second, the role of medical insurance
1 is conducive to improving labor productivity and promoting production development. Medical insurance is the inevitable result of social progress and production development. On the other hand, the establishment and perfection of medical insurance system will further promote social progress and production development. On the one hand, medical insurance relieves the worries of workers and enables them to work with peace of mind, thus improving labor productivity and promoting production development; On the other hand, it also ensures the physical and mental health of workers and the normal reproduction of labor.
2. Adjust the income gap and reflect social equity. Medical insurance is an important means for the government to redistribute income by collecting medical insurance premiums and paying medical insurance service fees. It is an important guarantee for maintaining social stability. Medical insurance provides economic assistance to sick workers, which helps to eliminate social instability caused by diseases and is an important social mechanism to adjust social relations and social contradictions. An important means to promote social civilization and progress. The social system of medical insurance and social mutual assistance embodies a new social relationship of "one party is in trouble and all parties support" by sharing the risk of disease costs among the insured, which is conducive to promoting social civilization and progress. An important guarantee for promoting economic system reform, especially the reform of state-owned enterprises.
Third, classification
1. Reimbursement medical insurance means that the medical expenses incurred by patients in the hospital are reimbursed by insurance companies, which are generally divided into outpatient medical insurance and inpatient medical insurance.
2. Compensatory medical insurance refers to the fact that the patient is definitely diagnosed with a certain disease listed in the contract by the hospital, and the insurance company pays the patient the treatment and nursing expenses according to the amount agreed in the contract. General personal illness insurance and critical illness insurance. The above two kinds of medical insurance have similarities and differences. Similarly, you can only get insurance if you are sick. The main difference is that general medical insurance belongs to all types, that is, all kinds of diseases can be insured. Special medical insurance belongs to a special category, that is, a certain disease or operation clearly listed in the insurance contract can get insurance compensation. Medical insurance introduced by insurance companies often combines some of the above two types of insurance. [3]
3. Types of subsidies
In short, subsidized medical insurance is medical insurance that the insurance company pays the insured according to the subsidy standard agreed in the contract and according to the time, date or project. Claims have nothing to do with actual medical expenses, and no invoice is needed. Medical insurance suggestion: When purchasing medical insurance, the first thing to consider is the reimbursement of medical expenses, and the second thing to consider is the compensation for losses caused by hospitalization. Only by consolidating the basic guarantee and supplementing it on this basis can we add icing on the cake. People with adequate social insurance can give priority to subsidizing medical insurance when choosing medical insurance.