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In recent years, the medical insurance departments at all levels in the province have continuously deepened the reform of "decentralization, management and service" in the field of medical insurance, what real benefits and convenience have these powerful measures brought to the vast number of market entities and the insured masses? On October 13, Li Xiangdong, Secretary of the Party Group and Director of the Hubei Provincial Medical Security Bureau, visited the portal of the Hubei Provincial People's Government and chatted with netizens about topics related to
medical security.
Host: Medical security is a major livelihood project
to reduce the burden of medical treatment on the masses and improve people's livelihood and well-being.
The medical insurance departments at all levels in the province resolutely implement the decision-making and deployment of the Party Central Committee and the State Council and the work requirements of the provincial party committee and the provincial government, continuously deepen the reform of "decentralization, management and service" in the field of medical insurance, help optimize the business environment, improve the level of government services, and bring real benefits and convenience
to the vast number of market entities and insured people.
Today, we are very honored to invite Comrade Li Xiangdong, Secretary of the Party Group and Director of the Provincial Medical Security Bureau, to be a guest interview column to introduce us to the medical insurance service
.
Director Li, welcome! Li Xiangdong: Hello netizens, hello
host.
Thank you very much for providing such a platform for communicating with you on the portal of the provincial government, and on behalf of the Provincial Medical Insurance Bureau, I would like to take this opportunity to express my heartfelt thanks to all walks of life and netizens for their concern and support for Hubei medical insurance work! Welcome netizens to put forward valuable opinions on our work! Host: Medical insurance involves everyone's vital interests and is a topic
of great concern to the majority of netizens.
Director Li, first of all, I would like to know what measures the medical insurance department has taken to optimize medical insurance services and improve the level of services for the convenience of the people, and what are the results? Li Xiangdong: Optimizing medical insurance services is always on the
road for our medical insurance department.
In recent years, the province's medical insurance system has vigorously promoted the reform of "decentralization, management and service", focusing on improving and optimizing services from the following five aspects, and continuously improving the public's work experience
.
The first is to strengthen the system and realize that medical insurance services are "manned"
.
We continue to strengthen the construction of medical insurance handling service system, and achieve full coverage
of the five-level handling service network at the provincial, municipal, county, township and village levels.
1,522 handling personnel were dispatched to 1,170 townships (neighborhoods), accounting for 31% of the total number of handling personnel in the province, and relying on party and mass service centers (community neighborhood committees), convenience service stations, village clinics and other positions, medical insurance services were extended to villages and communities, opening up the "last mile"
of serving the masses.
The second is to unify the project and realize the "standardized office"
of medical insurance services.
The province will uniformly standardize the medical insurance handling service items with different standards in various places into 10 categories and 28 items, and realize the "six unifications"
of name calling, project coding, materials provided, completion time limit, process links, and service standards.
Produce concise and clear operation guidelines for the masses, and announce them to the public through the official websites of medical insurance bureaus at all levels, official accounts and medical insurance service windows, effectively standardizing the public service behavior of medical insurance and making the masses more transparent and efficient
.
The third is to reduce materials and realize the "fast handling"
of medical insurance services.
In accordance with the principle of maximizing the benefit of enterprises and the people, we implement a commitment system for high-frequency service matters such as medical recordation in different places and payment of maternity insurance benefits, and after personal commitment, it can be directly completed
without providing other supporting materials.
At the same time, open up information and data sharing, rely on the national medical insurance service platform APP, Ehui office APP, provincial government service network and other channels, to achieve "online handling" and "palm handling" of medical insurance handling services, so that enterprises and the masses can submit less or even no materials
when doing things.
The fourth is to provide excellent services and realize the "intimate operation"
of medical insurance services.
Medical insurance handling services do not distinguish between insurance types and matters, and all are "handled through one window", that is, one window, non-discriminatory acceptance, and one-time handling
.
In order to improve and enhance the service environment, the unified construction of standardized service halls, the opening of self-service areas, to achieve "no face-to-face office"; Carry out age-appropriate transformation, and provide assistant agency services for special groups such as the elderly and the disabled; For special hardship groups, open up "green channels" to achieve emergency and special handling
.
Fifth, strengthen the grassroots level and realize the "nearby operation"
of medical insurance services.
In accordance with the principle of "if you can release it, you must release it as much as you can", high-frequency services such as urban and rural residents' insurance registration, information inquiry and change will be sunk to the
township and village levels.
Promote the identification of outpatient chronic diseases and newborn insurance to designated hospitals, so as to realize the "nearest office"
of medical insurance services.
Host: With the efforts of medical insurance departments at all levels, medical insurance services are becoming more and more convenient, and the public's experience is getting better and better.
Li Xiangdong: There are two main examples: One is the "joint handling of one matter"
.
In accordance with the principle of convenience for the people, we will take the lead of the medical insurance department but involve multi-department responsibility matters, comprehensively reshape and greatly simplify its handling process, through the data sharing of the information platform, to achieve the people only need to run one window at most, to achieve multi-department parallel acceptance and closure
.
In 2021, we will jointly handle the "medical expense reimbursement" in the province, and all the manual reimbursement of various medical expenses handled by the medical insurance department will be included in the joint scope, and the time limit for superimposed processing of related matters will be shortened from a maximum of 60 working days in the past to 15 working days, and from multiple runs in the past to a maximum of 1 run
.
Among them, the identification of medical assistance targets no longer requires the masses to run back and forth, but through our information exchange with the information system of civil affairs and other departments, to achieve reimbursement "one form application, one time done"
.
In 2022, we launched the reform
of "one thing for urban and rural residents to participate in medical insurance and pay premiums".
Among them, in view of the situation that some newborns need to be hospitalized at birth and must first apply for resident medical insurance enrollment for reimbursement after the fact, through the exchange of information and data with tax and other departments, newborn insurance is included in the joint scope, changing "two steps" to "one step", and solving the problem
of urban and rural residents registering and paying premiums in the past.
Another example is "inter-provincial access"
.
Breaking geographical restrictions, for high-frequency matters, the insured people can remotely handle Hubei's medical insurance business in other provinces, solving the blockage and difficulties such as running in many places and running back and forth
.
Up to now, we have realized the "cross-province handling"
of 7 high-frequency service items, including medical insurance electronic voucher application, insurance information change, urban and rural residents medical insurance enrollment registration, basic medical insurance relationship transfer and continuation, long-distance medical settlement filing, inter-provincial direct settlement of outpatient expenses, and basic information change of medical insurance designated hospitals.
Before the end of this year, the "inter-provincial handling" of "approval and payment of maternity insurance benefits"
will also be realized.
In the future, we will continue to follow the unified deployment of the National Medical Insurance Bureau and explore and promote more matters to be included in the scope of
"inter-provincial handling".
Host: Medical treatment in different places has always been a topic of concern to the public, can you introduce the specific measures for medical settlement in different places in terms of optimizing medical insurance government services and improving the level of convenient services? Li Xiangdong: Making the masses more satisfied is the unremitting pursuit and goal
of medical insurance people.
In 2011, our province realized the direct settlement of hospitalization expenses in different places in the province, and in 2017, it realized the direct settlement of inter-provincial hospitalization expenses; Since last year, we have vigorously promoted the direct settlement of general outpatient expenses and outpatient chronic and special disease expenses in different places, and the work of medical treatment in other places has continued to develop
.
In order to further improve the convenience of direct settlement for medical treatment in different places and facilitate the direct reimbursement of mobile personnel for medical treatment, since the beginning of this year, we have made great improvements mainly from the following aspects: First, in optimizing the medical registration services in different places First, the full coverage
of the filing population.
On the basis of the original four types of medical recordal types of "long-distance referral, long-distance resettlement, long-term residence in different places, and permanent work in different places", "other temporary medical personnel recorded" was added, which did not need to submit supporting materials, and after the identity verification was passed, it was directly reviewed and completed, covering all insured people
.
Second, the filing channels have been further expanded
.
The insured people can apply for filing through online channels such as the national medical insurance service platform APP, the national medical registration mini program, the Ehui Office APP, and the provincial government service network, so as to realize "palm office" and "online office"
.
Third, the filing service sinks
again.
The filing function has been sunk, and the handling level has been expanded from the three levels of province, city and county to the five levels
of province, city, county, township (street) and village (community).
For the elderly and other special insured people who are inconvenient to use mobile phones for filing, they can go to the nearest township (street) government service center and village (community) convenience service center for processing
.
Fourth, it is more convenient
to handle nearby.
The insured people can apply for medical treatment in different places at the township (street) government service center and village (community) convenience service center in the county of the participating place, and can apply for it within the county without household registration restrictions
.
Fifth, the procedures are simpler
.
For the three types of filing matters of "resettlement of retirees in different places, long-term residents in different places, and permanent staff in other places", a commitment system is implemented, and when the insured people do not bring information, they can not provide relevant supporting materials, and immediately close
it after signing the personal commitment letter.
Second, in standardizing the management of medical treatment in different places First, extend the validity period
of filing.
The three categories of personnel who need to stay in another place for a long time, such as retirement, long-term residence in another place, and permanent work in another place, are valid for a long time after filing for medical treatment in another place; The filing validity period of the other two types of temporary medical personnel in other places,It is valid for 6 months from the original one-time period, and you can visit the doctor multiple times and enjoy direct billing service
during the validity period.
The second is to increase supplementary filing services
.
Before the insured people are discharged from the hospital, they can apply for a supplementary record for medical treatment in another place, which will not affect the direct settlement of discharge; After settlement at your own expense, if you go through the filing procedures according to the regulations, you can apply for manual (sporadic) reimbursement of medical insurance from the place where you participate
.
Third, in terms of improving the reimbursement policy for medical treatment in different places, the first is to enjoy the medical insurance treatment
in both the place of filing and the place of participation.
After the insured people apply for the filing of medical treatment in different places, they can enjoy the direct settlement service of medical insurance at the same time in the place of enrollment and the place of medical treatment during the validity period of the record, and the medical insurance treatment will remain unchanged
.
Second, outpatient and drug purchase fees can be directly settled
.
Insured people do not need to file for the record when purchasing drugs in outpatient clinics and pharmacies
.
Employee medical insurance participants can use medical insurance electronic vouchers or social security cards to settle
directly in designated hospitals and pharmacies in different places.
There is no restriction on
the level and number of designated hospitals in which the insured people can seek medical treatment in other places.
Third, the cost of outpatient chronic disease can be directly settled
.
Outpatient chronic disease designated hospitals and pharmacies in the province recognize each other in the province
.
By the end of 2022, the province will realize the direct settlement
of five outpatient chronic diseases such as hypertension, diabetes, outpatient radiotherapy and chemotherapy for malignant tumors, uremic dialysis, and anti-rejection therapy after organ transplantation.
Moderator: Previously, we released the preview of this interview on the website, which received great attention from netizens and asked many questions, and we selected some questions with high attention, and asked Director Li to respond on the
spot.
A netizen of Jimu News asked, which hospitals can directly settle for medical treatment in different places? Li Xiangdong: Hospitals and pharmacies that are designated for medical treatment in different places can achieve direct settlement
in different places.
Previously, there were 807 designated hospitals and 764 designated pharmacies in our province, ensuring that at least 1 hospital in each county can implement direct settlement
of general outpatient and inpatient expenses.
This year, our province has added about 1,000 designated hospitals and about 6,000 designated pharmacies, including provincial and municipal hospitals, county-level people's hospitals, maternal and child health hospitals, traditional Chinese medicine hospitals, as well as township health centers, community health service centers, village clinics and other grass-roots medical institutions
.
This is also an important aspect of the improvement of medical treatment in different places in our province, and we hope to ensure that the public can seek medical treatment and direct settlement
by continuously expanding the coverage of designated medical institutions.
Host: Some netizens asked, I used to work in Shiyan, participated in the local employee medical insurance, and now come to Wuhan to work, can you transfer the original employee medical insurance to Wuhan? Li Xiangdong: Yes
.
The transfer of medical insurance enrollment relationship is one of
the 28 service items in 10 categories specified by our province.
In 2021, we have achieved "inter-provincial access" for this service, without geographical restrictions
.
You can directly handle
it in "Pocket" and "online".
After the transfer is completed, the funds in the personal account of the original place of insurance can be transferred to the new place of insurance for direct use, and the original number of years of insurance can also be combined into the new place of enrollment
.
Host: So how do you turn it? Li Xiangdong: The insured people can
apply on the handling platform specified by either party in or out of the place of transfer.
The insured people in our province can apply for application on
the national medical insurance service platform APP, the Ehui Office APP, and the provincial government service network.
If you don't know how to use mobile phones, you can also go to the medical insurance government hall of the place of transfer or transfer out and ask our staff to help you do it
.
Moderator: Thank you, Director Li, for your answer
.
As the medical insurance department continues to promote the reform of "one network, one door, one time" of government services, and constantly improves and innovates various measures for the convenience of the people, we believe that the level of medical insurance services will become better and better, and the medical insurance services enjoyed by the public will become better and better
.
Thank you again Director Li for being our guest on our program, thank you netizens for watching, we will see you
in the next issue.
Li Xiangdong: Thank you! Thank you to the host and friends for their concern and support for medical insurance work! The Provincial Medical Insurance Bureau will always adhere to the people-centered, focus on the urgent problems of the masses' medical security, and start from a little bit to make medical insurance services more beneficial and convenient for the people, more intimate and warm.
Welcome to put forward valuable opinions and suggestions on the work of medical insurance government services, and we will actively adopt and seriously improve
.
Good bye!
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