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B= 879;nh viện  BÌNH AN

QUY ĐỊNH

KH&Aacut= e;M CHỮA BỆNH BHYT

---oOo---

= A.&n= bsp;   = 2;ỐI TƯỢNG

B= 879;nh viện Bình An nhận khám chữa bệnh n= 897;i, ngoại trú cho các đối tượng BHYT :

1.      Có= ; thẻ BHYT đăng ký khám chữa bệnh ban đ&= #7847;u tại bệnh viện Bình An.

2.      Có thẻ BHYT đăng k&yacu= te; khám chữa bệnh ban đầu tại nơi khác được chuyển đến BV Bình= An

3.      BN BHYT ở các phường xã sau đây chỉ cần giấy giới thi&= #7879;u/chuyển viện của trạm y tế :

-      =     Các Tr̐= 1;m Y Tế (TYT), Phòng khám khu vực (PKKV) thuộc TP.Rạch Giá

-      =     TYT/PKKV Sóc sơn, Mỹ Lâm, Mỹ Phước huyện H&ograv= e;n Đất

-      =     TYT/PKKV Tân= Hội, Tân Thành, Thạnh Lộc huyện Tân Hi̓= 9;p

-      =     TYT/PKKV Mong Th&#= 7885; A, Mong Thọ B, Giục Tượng Huyện Châu Th&= #7843;nh.

-      =     TYT/PKKV Tây Yên, Tây Yên A huyện An Biên

4.      Tất cả các trườn= g hợp cấp cứu

5.      Trẻ em dưới 72 tháng t= uổi, cư trú tại TP Rạch Giá (Có mang theo = hộ khẩu hoạc giấy khai sinh)

* Từ 01/01/2010 tất cN= 43; các thẻ BHYT theo mẫu cũ đều không được sử dụng, tất cả các = 73;ối tượng BHYT đều phải sử dụng theo m&= #7851;u thẻ mới với mã thẻ gồm 15 ký t&= #7921; gồm chữ và số, có dạng:

 

 

 

 

 

=  

B.  PHƯƠNG THỨC THANH TOÁN.

1. Các trường hợp được BHYT thanh toán đúng theo nhóm đối tượ= ng và quyền lợi được h&= #432;ởng :

-      =     Có thẻ BHYT đăng ký khám ch= ữa bệnh ban đầu tại bệnh viện Bình A= n.

-      =     Có thẻ BH= YT đăng ký khám chữa bệnh ban đầ= ;u tại nơi khác được chuyển đến BV Bình An theo yêu cầu chuyên môn

-      =     Tất cả các bệnh nhân BHYT nhập viện vì bN= 79;nh lý cấp cứu

2. Các trường hợp được BHYT thanh toán 50% theo nhóm đối tượng và = quyền lợi được hưởng :

-      =     Có thẻ BHYT đăng ký khám ch= ữa bệnh ban đầu tại nơi khác nhưng có nhu cầu được khám, điều t= rị tại BV Bình An (áp dụng từ ngày 01/0= 1/2010)

= 3.&n= bsp;     Tất cả các đố= ;i tượng sẽ phải thanh toán thêm các khoản sau (nếu có) :

+ Chênh lệch giá giữa giá BHYT t= hanh toán và giá dịch vụ của Bình = An.

+  Phần đồng chi trả theo quy đ= ịnh của BHXH đối với từng nhóm đố= ;i tượng.

+  50% Theo giá BHYT thanh toán đ= ;ối với bệnh nhân khám, điều trị trái tuyến.

 

C.  MỨC QUYỀN LỢI TH= EO TỪNG NHÓM ĐỐI TƯỢNG :

Đối tượng

M&= atilde; đối tượng

M&= #7913;c

qu= yền lợi

Qu= yền lợi

Ch= ung (%)

Qu= yền lợi hưởng CP Vận

Ch= uyển

Qu= yền lợi trong t.toán DVKT

Ca= o (%)

Một s= ố NCC, TE<6T

CC,TE

1

100

Có

100

Người có công khác<= /o:p>

CK

2

100

Có

100/40

Công an<= /p>

CA

3<= /o:p>

100<= span style=3D'font-size:12.0pt;font-family:"Times New Roman";color:red'><= /o:p>

Không= <= /o:p>

100/40<= /o:p>

Bảo trợ, hộ nghèo

BT,HN

4<= /o:p>

95<= /o:p>

Có<= /o:p>

95/40<= /o:p>

Hưu trí

HT

5<= /o:p>

95<= /o:p>

Không= <= /o:p>

95/40<= /o:p>

Cận nghèo

CN

6<= /o:p>

80<= /o:p>

Có<= /o:p>

80/40<= /o:p>

Khác= <= /o:p>

Các mã khác

7<= /o:p>

80<= /o:p>

Không= <= /o:p>

80/40<= /o:p>

* 10= 0/40 : hưởng 100% nhưng không vượt quá 40 tháng lương tối thiểu (hiện nay là  730.000đ) cho một lần điều trị.

 = ;           <= /o:p>

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