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索 引 号: 秒速时时彩官网000345-02-2012-105927

发布日期: 2012-10-15

发布机构: 深圳市医疗保障局

文 号: 深社保发〔2009〕3号

名 称: 关于门诊使用抗排斥药化疗药和放疗介入治疗核素治疗医保门诊记账的通知

关于门诊使用抗排斥药化疗药和放疗介入治疗核素治疗医保门诊记账的通知

发布日期: 2012-10-15 12:35 来源:秒速时时彩官网_秒速时时彩注册_【官网推荐】

geyibaomenzhendabingzhenduanyiyuan、kangpaichiyaohualiaoyaoyibaodingdiangongyingyaodian、xiangguancanbaoren:

    genju《shenzhenshishehuiyiliaobaoxianbanfa》(shenzhenshirenminzhengfulingdi180hao)dexiangguanguiding,cong2009nian1yue1riqi,shenzhenshishehuiyiliaobaoxiancanbaoren(yixiajianchengcanbaoren)xuqiguanyizhihoumenzhenshiyongkangpaichiyao、exingzhongliumenzhenhualiao、jieruzhiliao、fangliaoyuhesuzhiliaode,pingbenrendeshehuibaozhangka(hanshenzhenshilaodongbaozhangka、shehuibaoxianzheng、yiliaobaoxianzheng)zaishenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuan、kangpaichiyaojihualiaoyaodeyibaodingdiangongyingyaodiangouyaozhiliaobingshuashehuibaozhangkajizhang(gaiyiyuanyaodianmingdanjianfujian,hualiaoyaodeyibaodingdiangongyingyaodianmingdanjijizhangkaishishishishijianlingxingtongzhi),shishijizhanghou,miaosushishicaiguanwangjubuzaijiyipingxianjinshouju(fapiao)dengbaoxiao。xianjiangyouguanjutiyaoqiutongzhiyixia:

    一、参保人办理记账的程序

    canbaorenyingxianzaishenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanbanlidierleimenzhendabingrending(2008nian4yueyilaianyibaoguidingyizuorendingdebubizairending),jingrendinghou,xiangshenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanzhuzhenyishengchujubenrende《shenzhenshishehuiyiliaobaoxianmenzhendabingzhuanyongmenzhenbingli》jilu,yougaiyishengtianxie《shenzhenshishehuiyiliaobaoxiandierleimenzhendabingzhiliaofangandengjibiao》(yishilianglian),yishenganguidingshuxieqingchucanbaorendebingqingzhenduan、yongyaozhiliaofangan(yaopinmingcheng、yongliang、yongfa)、zhiliaoliaochengdeng。gaidengjibiaoyilianjiaocanbaorenzhantiezaiqizijide《shenzhenshishehuiyiliaobaoxianmenzhendabingzhuanyongmenzhenbingli》nei,lingyilianyougaiyishengsuozaikeshifuzemeiyuejiaoyiyuanyibaobangongshibaocunjiandang,yibeishebaojigoujiancha。

    canbaorenzhiliaofanganyougenggaide,xuzhongxinzaianshangshuyaoqiubanli。anshangshuyaoqiubanlihoucanbaorenzhiliaofanganwugenggaide,xiaciyongyaozhiliaowuxuzaitianxie《shenzhenshishehuiyiliaobaoxiandierleimenzhendabingzhiliaofangandengjibiao》。

    二、开具处方或治疗单的规定

   (yi)shenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanzhuzhenyishengyingyangeheyancanbaorenheshehuibaozhangka。renkaxiangfude,anyibaodaiyukaijuchufanghuozhiliaodandeng。ruhuanzhebufuheyibaokashangxiangmaode,keyaoqiuhuanzhechujushenfenzhengheyan。

   (er)duiyoushiyingzhengyaoqiudeyaopin,yishengyingyangeanyibaoyaopinmulujiyaopinshuomingshuguidingshiyingzhengfanweikaiyao,chufangjiqitazhiliaofanganyinganyiliaochangguizhengquekaiju,chufangyaoliangzuizhangbuchaoguo30riyaoliang。

   (san)menzhenkangpaichiyaochufang、exingzhongliuhualiaochufang、fangliao、jieruzhiliaoyuhesuzhiliaozhiliaodanyingfenleikaiju。qiguanyizhihoumenzhenyongkangpaichiyao、exingzhongliumenzhenhuafangliao、jieruzhiliaoyuhesuzhiliaoshuyudierleimenzhendabing,jiancheng“tebing”。shenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanzhuzhenyishengyingdandukaiju“tebing”chufang、zhiliaodan,bingzaichufang、zhiliaodanyoushangjiaozhuming“tebing” erzi。zhiliaoqitajibing,bubanyoukangpaichiyao、hualiaoyao、exingzhongliumenzhenfangliao、jieruzhiliaoyuhesuzhiliaode,buxuzaimenzhenchufang、zhiliaodanbiaozhu“tebing” erzi。

   (si)zaiyibaodingdianyaodiangoumaikangpaichiyao、hualiaoyaode,shenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanyishengkaijude“tebing”chufangxuyoucanbaorenjiaoyiyuandeyibaobangongshishenhegaizhang。

    三、深圳市社会医疗保险门诊大病诊断医院及医保定点药店收费记账配药的规定

   (yi) jianyishangkangpaichiyao、hualiaoyao“tebing”chufang,huofangliao、jieruzhiliaoyuhesuzhiliaode“tebing”zhiliaodande,shoufeijizhangyuanyingyangeheyancanbaorenshehuibaozhangka,dianjiyibaoxinxidiannaoxitongmenzhen“tebing”lanmushoufeijizhang。

    (er)menzhenpeifayibaomuluneikangpaichiyao、exingzhongliuhualiaoyaoshi,yaofangyingxiangcanbaorenshuomingbingdangmiandakaibaozhuangbingjianquyaopinwaibaozhuanghe(huodai)deyijiao(danbuyaosunhuaibaozhuangneiyaopin、yaopinshuomingshu、yaopinpihao、shengchanriqi、youxiaoqiheshengchanchangjiadeyinshuaziyang),zaiwaibaozhuanghehuoyaopinshuomingshushangjiagai“yibaoyigou”zhang(huoyiyuanyewuzhang),zuoweiyibaoyijizhangyaopindebiaoji,yicizuzhigebiepianbaorenyuandaomaiyaopin。

   (san)yindiannaoguzhangweijizhanghuojizhangchuxianchacuode,youxiangguanyiyuanhuoyaodianzaisuihoujinkuaichulijiuzhengjizhang。

    四、参保人在异地开具抗排斥药处方的规定

    canbaorenyikejingqibenrendeqiguanyizhishoushuyiyuandeyishengkaijuqiguanyizhihoudemenzhenzhiliaoyongkangpaichiyaochufang。changzhuyididecanbaorenkexuanzeqibenrenyizaimiaosushishicaiguanwangjubeian《shenzhenshishehuiyiliaobaoxianchangzhuyidijiuyidengjibiao》shangdengjideyiyuandeyishengkaijuchufang。pingshangshuchufangzaishenzhenshidingdiangongyingkangpaichiyaodeyibaoyaodianshuashehuibaozhangkajizhanggoumaizhiliaobenrenjibingdekangpaichiyao。

    五、不能记账但可凭现金收据(发票)报销的规定

   (yi)yinbenrenqiguanyizhihoumenzhenyongkangpaichiyao、exingzhongliumenzhenhualiao、fangliao、jieruzhiliaoyuhesuzhiliaodechangzhuyidijiuyidecanbaoren,qibenrentianxie《shenzhenshishehuiyiliaobaoxianchangzhuyidijiuyidengjibiao》,xianzaimiaosushishicaiguanwangjudengjichangzhuyidijiuyide3jiayiliaojigou,ranhoukexuanzezhei3jiayiliaojigoudeyishengzhenzhi,youyishengshuxiemeicizhenzhigouyaodemenzhenjiuyijilu,kaijuchufang(meizhangchufangdeyaoliangbuchaoguo30ri),huokaijufangliao、jieruzhiliaoyuhesuzhiliaodan,jinxingxiangyingzhiliao。zhei3jiayiliaojigouwugongyingkangpaichiyao、hualiaoyaode,canbaorenzaiqudezheixieyiliaojigouzaichufangshangzhumingwuyaodeshuoming(gaiyiliaojigouyewuzhang)hou,kezaiyidiqitayiliaojigouhuoyaodiangouyao。xiangmiaosushishicaiguanwangjushenqingbaoxiaoshi,canbaorenxutigongshangshuyiliaojigougaizhangzhumingwuyaoshuomingdechufang(huofuyinjian)、menzhenbinglijilu、shoufeiqingdandeng。miaosushishicaiguanwangjubujiyijizhanghuobaoxiaozaiyidiyaodiangoumaihualiaoyaodefeiyong。

   (er)teshuqingkuang,zaishenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuan、yibaodingdiangongyingyaodianmeinengjishigongyingpaichiyao、hualiaoyaoshi,canbaorenxujingshenzhenshiyibaodingdiangongyingyaodianzaichufangshangzhumingwuyao(gaiyaodianzhang),zaisuihou5tianneidaoqitadanweigoumaikangpaichiyao、hualiaoyaodefeiyongkexiangmiaosushishicaiguanwangjushenqingxianjinshouju(fapiao)baoxiao。baoxiaoshi,canbaorenxutigongkangpaichiyao、hualiaoyaoyibaodingdiangongyingyaodiangaizhangdezhumingwuyaoshuomingdechufanghuofuyinjian。

    shangshuzaiyidigouyaozhiliao、zaibenshidaoqitadanweigoumaikangpaichiyao、hualiaoyaodekebaoxiaoqingxing,miaosushishicaiguanwangjuanbugaoyushenzhenshiyibaodingdiangongyingyaodiandeyibaolingshoujiajiyibaoxiao,bingzuohaodengjigongzuo。

    shenzhenshiyibaomenzhendabingzhenduanyiyuanweifanshangshuguidingdeanweiguichuli,miaosushishicaiguanwangjuanxiangyingweiguichufangjizhiliaojinezaiqitayiliaofeiyongjiesuanchangfukuanzhongkouchuweiguikuan。canbaorenweifanshangshuguidingde,miaosushishicaiguanwangjubuyubaoxiaoxiangguanyiliaofeiyong;canbaorennongxuzuojiade,miaosushishicaiguanwangjutingzhiqiyibaojizhanghebaoxiao,anyibaoyouguanguidingchuli。

    yishangmenzhentebing,shiyong“tebing”tongdaojizhang,yiliaobaoxianjiesuanxitongzidongjiangqiguanyizhihoumenzhenshiyongkangpaichiyao、exingzhongliumenzhenfang、hualiaohuojieruzhiliao、hesuzhiliaoyaowu90%yibaojijinjizhang,fuzhuzhiliaoyaowuzegerenzhanghuhuakou,gerenzhanghuyongwanhou,zaiqiyiliaobaoxiannianduneichaoguoshishangnianduchengzhenzhigongnianpingjungongzide5%yishangdebufenyibaojijinjizhang70%,qitayaowuanputongmenzhenconggerenzhanghukoujian,chaozhizili。kangpaichiyao、exingzhongliumenzhenhualiaoyaomulu、fuzhuzhiliaoyaowumuluyimiaosushishicaiguanwangjuhulianwangzhangongbudeweizhun。

 

    fujian: 1.shenzhenshishehuiyiliaobaoxianmenzhendabingzhenduanyiyuanmingdan

          2.shenzhenshikangpaichiyaoyibaodingdiangongyingyaodianmingdan

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