A total of 190 medical insurance settlement list data indicators
News from this reporter (reporter Xie Li) Yesterday, the National Medical Insurance Bureau issued the "Regulations for Filling in the Medical Insurance Fund Settlement List (Trial)" to unify the data collection standards for medical insurance settlement lists. According to the specifications, there are a total of 190 data indicators in the medical insurance settlement list, including 32 basic information parts, 6 outpatient chronic disease diagnosis and treatment information parts, 57 inpatient diagnosis and treatment information parts, and 95 medical charge information parts.
It is understood that the medical insurance fund settlement list (referred to as the "medical insurance settlement list") refers to the data list submitted by the medical insurance designated medical institution to the medical insurance department after carrying out medical services such as inpatient and outpatient chronic diseases.
According to the specifications, there are a total of 190 data indicators in the medical insurance settlement list, including 32 basic information parts, 6 outpatient chronic disease diagnosis and treatment information parts, 57 inpatient diagnosis and treatment information parts, and 95 medical charge information parts.
Basic information data indicators are mainly used for the identification of designated medical institutions and patients, including list serial number, designated medical institution name, designated medical institution code, medical insurance settlement level, medical insurance type, etc .; outpatient clinic chronic disease diagnosis and treatment information data indicators mainly reflect outpatient clinics The actual diagnosis and treatment of patients with chronic diseases. Inpatient diagnosis and treatment information data indicators mainly reflect the information of the whole diagnosis and treatment process of patients such as admission, diagnosis, treatment, and discharge, including the type of hospitalization, the way of admission, and the type of treatment.
The most important medical payment information data indicators include 95 data indicators, which mainly reflect the actual medical expenses when the designated medical institution and the patient checkout.
The standard requires that the medical insurance settlement checklist should be filled objectively, truthfully, in a timely and standardized manner, and the project should be completely filled out, accurately reflecting patient diagnosis and treatment, medical charges and other information.