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Live in a hospital, do three times the admission procedures
To avoid the "Medicare limit", the provincial capital of a Medicare patient urban residents are "exploded" in hospital
Lower case are in kindergarten, his parents attended medical insurance for urban residents in Jinan City. Originally figure is a guarantee when they are sick, and other hospital reimbursement Shique made difficult. Most recently,9H5OgH1XiG, he sudden acute suppurative appendicitis,woolrich sito ufficiale, in Jinan City, a top three health insurance designated hospital for surgery. Disposable hospital 12 days, but do three admission and discharge procedures,A96J9NEn26A96J9NEn26, only to avoid the "reimbursement limit", and the total cost of 20,000 yuan, only 2,000 yuan reimbursed.
Yuan Hong newspaper intern reporter Zhang Yanan
[Strange]
They do not discharge it on the readmission procedures
On the 20th,woolrich sito ufficiale, Mr. Meng grandfather lower case showed reporters the hospital bills and hospital medical record fee. Inpatient medical record showed lower case on October 2, respectively, in the afternoon, at 14:00 on October 4 and more and at 15:00 on the 8th hospitalized three times more than the corresponding in at 17:00 on October 4th,peuterey outlet, at 16:00 on October 8 more and at 11:00 on October 13 there were three hospital discharge records.
Hospital charges bills show first hospitalization spent 11,300 yuan, the second hospital spent 6649 yuan, the third time in hospital spent 2422 yuan. Where the first and third inpatient hospitalization at their own expense,moncler sito ufficiale, the second hospital by medical insurance for urban residents, spent a total of 6649 yuan, 2163 yuan which reimbursement.
As can be seen from the hospital medical records, lower case three times even the existence of admission and discharge cross, after the first admission, not discharged, there is a second admission records. Why is this?
Mr. Meng told reporters,nike requin tn, in fact,58tOmJT3aG,chaussures nike pas cher, is run twice a false admission formalities. "My grandson October 2 PM hospitalized because of acute appendicitis surgery, 13 pm out that 12 days have been hospitalized."
The reason
Medicare reimbursement for the use of forged twice the admission procedures
Why go through two additional false admission and discharge procedures, will be broken down into three primary hospitalization it? Mr. Meng explained that "can point to Medicare,woolrich donna, or a penny not reported."
Mr. Meng said that during the 2nd for the first time to see a doctor, heard small characters are urban residents to participate in Medicare, doctors do not want to receive, it is recommended to Jinan City Children's Hospital for treatment. But Mr. Meng think the top three hospitals and more trustworthy. The doctors agree admitted, but said only at their own expense,chaussures nike pas cher, Jinan City, Medicare can not be used, light surgery would have cost about a thousand dollars. "Watching the children hurt like that, we feel bad, at their own expense to expense it." Mr. Meng said.
However, looking at the rising cost of treatment, Mr. Meng one or surprised. "We have to discuss with the doctor,338Wuq8pbX, can not be reimbursed by Medicare part to reduce spending point, so the doctor gives an idea,woolrich giubbotti,9rQYk8L424, apply three times the admission formalities." Mr. Meng said.
But doctors said that reimbursement can only go up to 6000 yuan in medical expenses, the second time in hospital is to be reimbursed tailored October 4th to 8th. Receipts show that the cost of 6000 yuan, 2163 yuan eventually reimbursed.
[Hospital]
Children have more than 6000 yuan quota limit reimbursement
It is understood that lower case to join the urban residents in Jinan basic medical insurance, the premium paid 40 yuan a year. Jinan health insurance for urban residents insured residents an inherent level of annual medical inpatient medical institutions, the personal burden of 20%,woolrich parka, medical insurance fund 80% of the burden of residents, from the pay line of 200 yuan; in secondary care medical and personal burden 35% of the burden of health insurance fund 65% of residents, from the pay line of 400 yuan; in tertiary care medical institutions, 45% of the personal burden, the burden on the residents medical insurance fund 55%, from the pay line of 700 yuan.
According to the Office of Jinan City, Medicare staff, from 700 yuan to pay the line started, up to 15 million in three hospital reimbursement is 55%. However, this does not mean that 55% of the total cost can be reimbursed,[/url], as well as checking the different classes of drugs,[url=http://www.megliomilano.it/]moncler outlet, treatment will affect reimbursement. The hospital treatment, drugs, supplies, and other inputs to check the health insurance system, the system will automatically calculate the reimbursement amount.
Lower case in a hospital do appendicitis surgery spent more than 20,000 yuan, according to the Medicare office staff, if not the first hospitalization expense and once broken down into two Medicare reimbursement amount will be much higher than 2000 yuan.
So, why would a hospital only three times in order to be reimbursed for the decomposition of it? Why be included in the total amount of the reimbursement of only 6,000 yuan it?
In this regard, the hospital responsible people do not want to say, only that for urban residents in Jinan City,hcTi8ljV67, Medicare pediatric patients, municipalities do have Medicare reimbursement quota limit of 6,000 yuan, the hospital is completely in accordance with the provisions of the Medicare do things.
[Medicare] do
Times per capita quota restrictions for specific treatment violation
What exactly is the hospital in accordance with the rules? Medical insurance for urban residents,moncler sito ufficiale, Jinan Medicare reimbursement provisions do if quota of 6,000 yuan?
In this regard, Jinan City,FFRChLLP20, Medicare and Social Council Office official said, the per capita expenses of Jinan City, the basic medical insurance for urban residents of patients have a fixed standard. In most tertiary hospitals, 2013 in Jinan urban residents basic medical insurance for a fixed fee per second child is 6090 yuan. If the per capita health care costs over time 6090 yuan, more than the cost to be borne by the hospital.
However, the official stressed that the per capita cost of the fixed times is the average cost of a hospital patient admitted to the full year, but when the insurance sector and the designated hospitals for the year-end closing, the specific cost of treatment per patient is not handicapping. In this case, lower case, by decomposing inpatient hospital patient reimbursement restrictions are irregularities, the patient supervision departments by Medicare for hospital treatment. |
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發表於 2015-2-5 10:50:03
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