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先诊疗 后付费 零起付 免费治

2017-08-25 06:46:19   中国青年网

所谓个性化治疗方案,就是按照健康扶贫的相关要求,组织各县(市)区针对贫困患者的医疗救治实施“一人一策”和分类救治,在各级医院医师的巡诊基础上,为每一位参合的贫困患者建立“一人一策”记录本,内容包括患者的现病史、既往史、主要疾病诊断、确诊医疗机构、治疗方案等内容,还有巡诊随访记录,以便更好地掌握患者病情并指导治疗。同时,按照贫困患者的病情,建立分类救治的台账,明确什么病情由哪个部门负责,属于县级医疗机构指导下基层医疗机构长期治疗和健康管理的疾病,在县乡级医疗机构诊疗;需要转到市级医疗机构治疗的疾病,积极落实转诊治疗等等。

贫困百姓持有效证件无需缴纳住院押金即可住院治疗

针对贫困百姓就医实施先诊疗后付费政策,降低农村贫困人口就医门槛,贫困患者持医保卡(新农合医疗证)、有效身份证(户口本)和扶贫部门出具的贫困证明或民政部门出具的低保、特困等有效证明(证件),无需缴纳住院押金,即可住院治疗;出院时,仅需缴纳个人应承担的医疗费用部分,即可办理出院手续。

患者在办理“先诊疗、后付费”手续时,须与医疗机构签订《“先诊疗、后付费”住院费用结算协议书》,并将新农合证原件及本人身份证(户口本)复印件交医疗机构保管。同时,提交村委会开具、乡(镇)政府盖章确认的建档立卡贫困户证明。

在患者出院时,只需承担扣除新农合补偿和医疗救助或者新农合补偿之后的个人费用部分。如果个人承担医疗费用能一次性结清的,医疗机构应及时归还患者的有关证件,并办理出院手续;确因家庭困难,不能一次性结清的,可到所在村委会开具困难证明,加盖乡(镇)政府公章后,与医疗机构签订《“先诊疗、后付费”住院费用延期(分期)还款协议书》,还款期限由医疗机构视具体情况确定,然后再办理出院手续。确实需长期住院且医疗费用较高的患者,医疗机构可根据实际情况,制订医疗费用分阶段结算具体办法,并与患者签订还款协议书,逐步收回个人应承担的医疗费用,保证机构正常运行。

健康扶贫报销补偿政策实行“即时结算” 患者出院当日就能拿到报销款

为方便广大贫困患者就医,我市卫生计生部门和各级扶贫部门密切配合,多次比对了建档立卡贫困户名单和新农合参合人员信息,确保二者信息同步。目前,市扶贫办在册的贫困参合患者,在医疗机构就诊时,只要提供身份证就可以在新农合平台上显示出贫困户身份,享受到健康扶贫政策。

怕农民“看不起病”,我市县乡两级公立医疗服务机构住院治疗实施低比例补偿段项目,也就是老百姓所说的“零起付”,农村贫困参合患者在县级、乡级住院的低比例补偿段,也就是大家说的起付线,也按照住院比例进行报销,即县级公立医疗机构报销85%,乡镇卫生院报销95%。举例来说,一位贫困患者在乡镇卫生院就诊,按照原来的政策,普通住院500元以下,新农合报销30%,150元,自付350元;按照现行扶贫政策,报销95%,475元,自付25元,报销比例提高了65%。

为了减轻患者的经济负担,简化报销程序,按照我市规定,健康扶贫报销补偿政策实行“即时结算”,医疗机构设立单独的扶贫窗口,对报销金额先行垫付,患者出院当日就能拿到报销款。

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