摘要
广州医保通过对尿毒症透析治疗门诊特定项目实施"五定二审+专项稽核"的精细化管理,加大打击欺诈骗保的力度,保障社会医疗保险基金合理、有效、安全使用。本文就广州市医疗保险门诊特定项目尿毒症透析治疗的待遇标准、准入条件、就医管理进行分析,探索合理的制度设计和经办业务精细化管理成效。
Through implementation of meticulous management of dialysis treatment of uremia on specific clinic items,Guangzhou medical insurance department has vigorously cracked down on fraud insurance and ensured the rational, effective and safe use of social medical insurance funds.This article analyzes the treatment standard, admittance condition and medical treatment management of dialysis treatment of uremia in Guangzhou medical insurance, to explore reasonable system design and effective management.
作者
罗加亮
颜国强
江静
林国良
林铭伟
陈棠
Luo Jialiang Yah Guoqiang Jiang Jing Lin Guoliang Lin Mingwei Chen Tang(Guangzhou Medical Insurance Service Adminstration, Guangzhou, 510000)
出处
《中国医疗保险》
2017年第7期47-50,共4页
China Health Insurance
关键词
医疗保险
门诊特定项目
尿毒症
透析治疗
精细化管理
medical insurance,specific items of clinic, uremia, dialysis treatment, meticulous management
