Zibo: 23 types of TCM day-time diagnosis and treatment services are included in medical insurance settlement

Reporter Ma Yushu Correspondent Liu Lulu

On the afternoon of April 28, the opening ceremonies of Zibo Traditional Chinese Medicine Day Clinic were held at the Municipal Hospital of Traditional Chinese Medicine and the Municipal Hospital of Integrated Traditional Chinese and Western Medicine.

“The first batch of selected Chinese medicine has obvious advantages, clear clinical path, mature diagnosis and treatment technology, controllable medical quality, and medical safety can be guaranteed. 23 types of TCM such as syndrome, stroke, facial paralysis and other 23 types of TCM diagnoses and 49 kinds of diseases diagnosed by Western medicine, as the pilot medical insurance settlement of TCM daytime diagnosis and treatment.” said Hao Qifeng, member of the party group of the Municipal Medical Insurance Bureau and director of the Municipal Medical Security Service Center.

It is understood that the Zibo Municipal Medical Insurance Bureau has carried out pilot work in the second-level and above Chinese medicine medical institutions such as the Municipal Traditional Chinese Medicine Hospital and Zibo Integrated Traditional Chinese and Western Medicine Hospital. The pilot medical institutions give full play to the advantages of traditional Chinese medicine, which is “simple, convenient, testable, and inexpensive”, to provide insured patients with traditional Chinese medicine such as acupuncture, moxibustion, massage therapy, bloodletting therapy, acupuncture therapy, traction therapy, and traditional Chinese medicine package therapy. Special treatment.

“The pilot medical insurance settlement of TCM diagnosis and treatment expenses for diseases incurred by the insured at the TCM day-care center will be included in the city’s regional point method total control and payment settlement according to the disease category.” Hao Qifeng Said, “The starting payment standard and reimbursement ratio shall follow the inpatient reimbursement policy of the basic medical insurance of the same level of medical institutions, and the starting payment standard, payment limit and hospitalization shall be calculated together.”

It is reported that during the treatment period of the insured, the bed Fees and nursing fees shall be charged at 30% of the current charging standard; if it is necessary to withdraw from the day-to-day diagnosis and treatment management of traditional Chinese medicine due to changes in the condition, settlement shall be made according to the original settlement method.

In addition, the medical expenses of the pilot diseases incurred in the day-time diagnosis and treatment of traditional Chinese medicine in the pilot medical institutions, including the detailed medical expenses of traditional Chinese medicine diagnosis and treatment items, auxiliary examinations, traditional Chinese medicine decoction pieces (including traditional Chinese medicine formula granules) and traditional Chinese medicine preparations in the hospital, according to The regulations are uploaded to the medical insurance settlement system to form a complete and accurate medical insurance fund settlement list. The medical insurance agency shall settle settlements with the pilot medical institutions in accordance with the Zibo City regional point method total control and the disease type point value payment method.