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全市医保经办服务水平不断提升

全(quan)市医(yi)保(bao)系统(tong)秉(bing)持(chi)“以(yi)人(ren)民为中(zhong)(zhong)心”理(li)(li)(li)念,不(bu)(bu)断改进创新医(yi)保(bao)经(jing)(jing)办(ban)(ban)(ban)(ban)服(fu)务(wu)(wu)(wu),方(fang)(fang)便人(ren)民群众(zhong)看病就医(yi)。一(yi)(yi)是医(yi)保(bao)经(jing)(jing)办(ban)(ban)(ban)(ban)中(zhong)(zhong)心医(yi)疗(liao)(liao)保(bao)险(xian)申报窗(chuang)口(kou)入驻(zhu)市政(zheng)(zheng)府政(zheng)(zheng)务(wu)(wu)(wu)服(fu)务(wu)(wu)(wu)中(zhong)(zhong)心,实(shi)(shi)现医(yi)疗(liao)(liao)保(bao)险(xian)参(can)(can)保(bao)登记(ji)、核定(ding)(ding)、缴费(fei)(fei)“一(yi)(yi)站(zhan)(zhan)式”办(ban)(ban)(ban)(ban)理(li)(li)(li),解决“两头跑(pao)(pao)”“多次跑(pao)(pao)”问(wen)题(ti)。二是编制了(le)统(tong)一(yi)(yi)规范的(de)服(fu)务(wu)(wu)(wu)事(shi)项(xiang)办(ban)(ban)(ban)(ban)事(shi)指(zhi)南(nan)和政(zheng)(zheng)务(wu)(wu)(wu)服(fu)务(wu)(wu)(wu)事(shi)项(xiang)清单,明(ming)确(que)细化(hua)了(le)22项(xiang)服(fu)务(wu)(wu)(wu)事(shi)项(xiang)设(she)定(ding)(ding)依据、受理(li)(li)(li)条(tiao)件(jian)、办(ban)(ban)(ban)(ban)事(shi)材料(liao)(liao)、办(ban)(ban)(ban)(ban)理(li)(li)(li)流程、办(ban)(ban)(ban)(ban)理(li)(li)(li)时(shi)限、办(ban)(ban)(ban)(ban)理(li)(li)(li)地(di)(di)点、咨询方(fang)(fang)式、监督投(tou)诉(su)方(fang)(fang)式等(deng)内容。三是精简(jian)证(zheng)明(ming)材料(liao)(liao)和办(ban)(ban)(ban)(ban)事(shi)流程,全(quan)面简(jian)化(hua)报销手(shou)续,减少业(ye)(ye)务(wu)(wu)(wu)经(jing)(jing)办(ban)(ban)(ban)(ban)证(zheng)明(ming)事(shi)项(xiang),参(can)(can)保(bao)人(ren)员医(yi)疗(liao)(liao)费(fei)(fei)用零(ling)星报销时(shi),除提(ti)(ti)供(gong)必须的(de)医(yi)疗(liao)(liao)费(fei)(fei)用发(fa)票、病案(an)尊(zun)龙、费(fei)(fei)用明(ming)细清单汇总及住(zhu)院(yuan)(yuan)病历外(wai),不(bu)(bu)再需要提(ti)(ti)供(gong)其他证(zheng)明(ming)材料(liao)(liao);异(yi)地(di)(di)备(bei)案(an)只(zhi)提(ti)(ti)供(gong)异(yi)地(di)(di)备(bei)案(an)登记(ji)表(biao);生(sheng)育(yu)(yu)待遇(yu)申领(ling)仅提(ti)(ti)供(gong)生(sheng)育(yu)(yu)津贴(tie)待遇(yu)申领(ling)表(biao)、住(zhu)院(yuan)(yuan)医(yi)疗(liao)(liao)费(fei)(fei)用发(fa)票、住(zhu)院(yuan)(yuan)病案(an)、费(fei)(fei)用明(ming)细清单、生(sheng)育(yu)(yu)登记(ji)证(zheng)明(ming)、出生(sheng)医(yi)学证(zheng)明(ming)(市外(wai)),无须提(ti)(ti)供(gong)额外(wai)证(zheng)明(ming)材料(liao)(liao)。四是完善“一(yi)(yi)站(zhan)(zhan)式服(fu)务(wu)(wu)(wu)、一(yi)(yi)单式结(jie)(jie)算(suan)(suan)、一(yi)(yi)窗(chuang)口(kou)办(ban)(ban)(ban)(ban)理(li)(li)(li)”,解决参(can)(can)保(bao)群众(zhong)“垫资、跑(pao)(pao)腿(tui)、报销周期长”的(de)问(wen)题(ti)。五是去年新冠肺炎疫情爆发(fa)后,通(tong)过(guo)电(dian)话(hua)(hua)、微信(xin)、QQ等(deng)提(ti)(ti)供(gong)经(jing)(jing)办(ban)(ban)(ban)(ban)服(fu)务(wu)(wu)(wu)和预约服(fu)务(wu)(wu)(wu),积(ji)极引(yin)导参(can)(can)保(bao)群众(zhong)和参(can)(can)保(bao)单位(wei)通(tong)过(guo)网(wang)上(shang)办(ban)(ban)(ban)(ban)、电(dian)话(hua)(hua)办(ban)(ban)(ban)(ban)、邮寄办(ban)(ban)(ban)(ban)、上(shang)传资料(liao)(liao)办(ban)(ban)(ban)(ban)等(deng)“不(bu)(bu)见(jian)面”服(fu)务(wu)(wu)(wu)方(fang)(fang)式办(ban)(ban)(ban)(ban)理(li)(li)(li)业(ye)(ye)务(wu)(wu)(wu),在(zai)省内率先上(shang)线推(tui)广(guang)了(le)国家异(yi)地(di)(di)就医(yi)备(bei)案(an)小程序。六是基本实(shi)(shi)现了(le)符合条(tiao)件(jian)的(de)跨(kua)省异(yi)地(di)(di)就医(yi)患者(zhe)在(zai)所有定(ding)(ding)点医(yi)院(yuan)(yuan)住(zhu)院(yuan)(yuan)直接结(jie)(jie)算(suan)(suan)。不(bu)(bu)断加(jia)大医(yi)保(bao)电(dian)子凭证(zheng)推(tui)广(guang)、激活力度(du),推(tui)行“就医(yi)购(gou)药不(bu)(bu)带卡,看病只(zhi)需医(yi)保(bao)码”的(de)便捷服(fu)务(wu)(wu)(wu)。七是打(da)造温馨优质经(jing)(jing)办(ban)(ban)(ban)(ban)窗(chuang)口(kou)。目前市医(yi)保(bao)中(zhong)(zhong)心经(jing)(jing)办(ban)(ban)(ban)(ban)大厅设(she)置15个经(jing)(jing)办(ban)(ban)(ban)(ban)服(fu)务(wu)(wu)(wu)窗(chuang)口(kou),大厅内部设(she)置等(deng)候休息区和便民服(fu)务(wu)(wu)(wu)点,配备(bei)饮水机、老花(hua)镜、稿纸、签(qian)字笔等(deng)便民设(she)备(bei),意见(jian)建议箱,张贴(tie)了(le)监督举报电(dian)话(hua)(hua),合理(li)(li)(li)增加(jia)了(le)绿植。八是努力提(ti)(ti)升干(gan)部服(fu)务(wu)(wu)(wu)本领(ling)。高(gao)(gao)度(du)重(zhong)视干(gan)部队伍思想政(zheng)(zheng)治教育(yu)(yu)、爱岗敬(jing)业(ye)(ye)教育(yu)(yu)、职(zhi)业(ye)(ye)道(dao)德教育(yu)(yu)、警示教育(yu)(yu)和业(ye)(ye)务(wu)(wu)(wu)学习(xi),开展“六S”管理(li)(li)(li)礼仪培训,通(tong)过(guo)加(jia)强学习(xi)、培训,引(yin)导干(gan)部职(zhi)工钻研业(ye)(ye)务(wu)(wu)(wu)、提(ti)(ti)高(gao)(gao)技(ji)能、增长才干(gan)、争创一(yi)(yi)流。结(jie)(jie)合党史学习(xi)教育(yu)(yu),积(ji)极开展“我为人(ren)民办(ban)(ban)(ban)(ban)实(shi)(shi)事(shi)”实(shi)(shi)践(jian)活动,形成了(le)务(wu)(wu)(wu)实(shi)(shi)担当、真抓实(shi)(shi)干(gan)的(de)良好(hao)氛围。

下一步,我们将尽快按照中省市相关要求配备政务服务硬件设施,加快医保信息化建设步伐,为医保经办工作提质增效提供技术支撑,大力推行网上申报缴费、网上稽核监督、线上结算划拨、线上查询交流,为参保群众提供安全、高效、优质、快捷的经办服务。(市医疗保障局)

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