Recently, the reporter learned from Jiangsu Medical Insurance Bureau that Jiangsu Medical Insurance continued to consolidate and expand the theme of education achievements, adhere to the problem orientation, focus on the pain points of the masses in the field of medical insurance, and launch eight practical matters of people's livelihood of medical insurance in 2024, which is also the annual practical matters of people's livelihood of medical insurance launched by Jiangsu Medical Insurance Department for four consecutive years.
Deepen and improve the long-term care insurance system to provide professional care for disabled families
Uncle Yang, who lives in Nantong, is unable to take care of himself due to progressive supranuclear paralysis, Parkinson's and other diseases, and is assessed as severely disabled. Since his wife could not take care of him alone, he moved into Nantong Sunshine Elderly Apartment. By the end of December 2023, the long-term care insurance has paid nearly 60000 yuan for the elderly, greatly reducing the pressure on the elderly and their families.
In order to actively respond to the aging population, on the basis of pilot projects and gradual promotion, the provincial government has listed the promotion of "long-term care insurance" as a practical matter for the private sector for two consecutive years. At present, our province takes the lead in achieving full coverage of all district and city systems. Since the pilot implementation of the system, the number of insured people in the province has exceeded 60 million, and the cumulative benefits enjoyed nearly 500000 people.
This year, the provincial medical insurance bureau will, according to the unified deployment of the National Bureau, establish a long-term care insurance system, encourage and guide qualified regions to steadily expand the coverage of the system, improve the policy standard system, effectively reduce the economic and transactional burden of the disabled family, and effectively solve the problem of "one person is disabled, the whole family is unbalanced".
Realize the full coverage of all village (community) medical insurance public services in the province, and make it more efficient and convenient to handle medical insurance business "at home"
Mr. Cao from Beilin Community, Dongting Lake Street, Tinghu District, Yancheng City needs to go to Shanghai to see a doctor because of his illness. In order to reduce the burden of advance payment, he urgently wants to know whether he can directly use the medical insurance card for settlement. Under the guidance of the electronic map of medical insurance, Mr. Cao successfully found the medical insurance agency service point in his community, and handled the off-site medical record formalities at the "gate".
It is understood that by the end of 2023, all village (community) medical insurance public service points in Jiangsu can provide 2 direct handling items such as urban and rural residents' insurance registration, insurance information query of insured persons, and 13 assistant handling items such as personal account query of medical insurance, online application for long-term non local residents' registration, online application for medical insurance relationship transfer and continuation.
This year, the Jiangsu Provincial Medical Insurance Bureau will promote the construction of village (community) medical insurance public service points with high quality and high standards. By reasonably allocating necessary service equipment and facilities, it will enrich a certain number of full-time and part-time medical insurance service personnel, and provide a series of basic medical insurance public services such as medical insurance policy publicity, business handling, insurance mobilization, deputy agency, and door-to-door services for grass-roots insured people, Continuously improve the public service level of primary medical insurance.
By the end of 2024, Jiangsu will basically achieve 100% coverage of all village (community) medical insurance public services in the province, and continue to open the "capillaries" of medical insurance services.
Deeply promote the whole process application of medical insurance code in designated medical institutions, and optimize the service experience of medical insurance convenience
Recently, Mr. Sun, a citizen of Xuzhou, told the reporter, "In the past, when paying at the window of the Fifth People's Hospital of Xuzhou, the medical insurance code and self payment code needed to be displayed many times, which was tedious and time-consuming. Now, with the" one code payment "service, the settlement of" medical insurance+self payment "can be completed after the display of the medical insurance code once, greatly simplifying the payment process and improving the efficiency of medical treatment, It reduces the time for patients to wait in line at the window. "
This year, Jiangsu provincial and municipal medical insurance departments will work together to play the role of medical insurance code as the "golden key" in the medical insurance service system, and constantly innovate the "Internet+medical insurance" service model. Promote the application of medical insurance code in the whole scene and process of medical treatment and drug purchase, continue to optimize and improve the electronic prescription, electronic bill, mobile payment, credit payment, "one code payment" and other convenient service functions, comprehensively promote the comprehensive medical insurance service terminals, and build a new ecosystem of medical insurance convenient service mainly marked by medical insurance code.
Optimize the process of drug and medical consumables networking, and complete networking within 15 working days
Judging from the implementation of the new process on March 1 this year, the time for enterprises to apply for online connection was significantly reduced, and the response of enterprises was enthusiastic. Taking a medical technology company in Changzhou as an example, 31 ablation electrode dissectors of the company were submitted to the Internet on March 10, and were publicized only five days later. After no objection to the publicity, they were announced to the Internet on March 22. The next day after the announcement of the declaration results, they could be purchased in the whole province. The whole process was handled for only 10 working days, which strongly supported the rapid marketing of enterprise products.
This year, Jiangsu Provincial Medical Insurance Bureau will innovate and implement the enterprise commitment system, further reduce the audit content, optimize the work process, achieve "daily and daily audit", and complete the whole process of product online service within 15 working days. Strengthen the collaboration between online and medical insurance payment, realize the seamless connection between online, procurement and medical insurance payment, and effectively improve the quality and efficiency of services that benefit enterprises and people.
In addition, Jiangsu medical insurance department will further promote the "efficient completion of one thing" in the field of medical security, promote the realization of direct settlement of maternity medical expenses and maternity allowance payment "free of application and enjoyment", comprehensively promote the "credit medical treatment" work of medical insurance, and carry out the pilot project of medical treatment expenses in different places in the province to be included in DRG payment of medical treatment.
Yangzi Evening News/Ziniu Journalist Yu Dandan
