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新农合异地结算加速度 破异地就医难“魔咒”

2017-09-08 11:07:23   新华网

2016年以来,中国人寿积极与国家新农合异地就医结算管理中心合作开展跨省就医联网结算工作,助推参合农民实现异地就医结算。据介绍,为确保跨省结算工作的顺利开展,中国人寿充分发挥出省级经办作用。通过联通外省医院与海南省经办机构,建立起“资金通”,缩短回款时间,解决医院垫付后资金回笼的压力,实现了“医院先垫付,群众少负担”。同时,开设银行专用账户,用于参合患者跨省异地就医联网结算垫付资金的周转,实行“封闭运行、专款专用”。中国人寿在接收到垫付医院提交的跨省就医结算垫付资金回款申请后,及时向联网医疗机构拨付垫付资金回款,再由海南省各市县合管办向中国人寿支付垫付款项。

自2015年10月起,中国人寿承办了海南省大病保险业务,按照服务协议的要求,及时配备了专兼职管理和服务人员38人。2016年起,已与海南省新农合定点医疗机构实现大病保险联网结算,并探索开展跨省联网结算服务。

实际上,通过中国人寿建立1亿元额度的跨省就医周转金以及高效结算服务,极大缓解了医疗机构和参合省份资金周转的压力,缩短回款时间,提高了医疗机构参与这项工作的积极性。

“中国人寿参与这项工作后,大大加快了资金周转,在收到国家新农合异地就医结算管理中心提交的医疗机构垫付资金申请后,均在1个工作日内完成资金拨付工作,医疗机构平均回款周期仅10天。”上述海南省卫生计生委负责人表示。

据了解,目前中国人寿已于与贵州、江苏等省份签订了新农合大病保险省内异地即时结算协议,开展省内大病保险“一站式”即时结算工作,减轻了参合患者的医疗费用负担,助推精准扶贫。

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