1、 医保,自查报告篇一：医保自查报告 医保自查报告 人力资源和社会保障局: 我院按照滦南县人力资源和社会保障局关于转发唐人社办【2013】21号文件“两定点”单位管理的通知等文件精神，经我院相关工作人员的努力，对于我院就诊的参保人员进行全面梳理，未发现费用超标、借卡看病、超范围检查、挂牌住院、以药换药、以物代药等情况，在一定程度上维护了医保基金的安全运行。现将自查工作情况作如下汇报： 一、医疗保险基础管理： 1、我院成立有分管领导和相关人员组成的基本医疗保险管理小组，具体负责基本医疗保险日常管理工作。 2、各项基本医疗保险制度健全，相关医保管理资料按规范管理存档。 3、医保管理小组定期组织人员对
2、参保人员各种医疗费用使用情况进行分析，如发现问题及时给予解决，不定期对医保管理情况进行抽查，如有违规行为及时纠正并立即改正。 4、医保管理小组人员积极配合县社保局对医疗服务价格和药品费用的监督、审核、及时提供需要查阅的医疗档案和相关资料。 二、医疗保险服务管理： 1、提昌优质服务，方便参保人员就医。 2、对药品、诊疗项目和医疗服务设施收费明码标价，并提供费用明细清单，坚决杜绝以药换药、以物代药等违法行为发生。3、对就诊人员进行身份验证，坚决杜绝冒名就诊及挂牌住院等现象发生。 4、对就诊人员要求或必需使用的目录外药品、诊疗项目事先都证求参保人员同意并签字存档。 5、经药品监督部门检查无药品质量问
3、题。 三、医疗保险业务管理： 1、严格执行基本医疗保险用药管理规定，严格执行医保用药审批制度。 2、达到按基本医疗保险目录所要求的药品备药率。 3、检查门诊处方、出院病历、检查配药情况均按规定执行。 4、严格执行基本医疗保险诊疗项目管理规定。 5、严格执行基本医疗保险服务设施管理规定。 四、医疗保险信息管理： 1、我院信息管理系统能满足医保工作的日常需要，在日常系统维护方面也较完善，并能及时报告并积极排除医保信息系统故障，确保系统的正常运行。 2、对医保窗口工作人员操作技能熟练，医保政策学习积极。 3、医保数据安全完整。 五、医疗保险费用控制： 1、严格执行医疗收费标准和医疗保险限额规定。 2
4、、严格掌握入、出院标准，未发现不符合住院条件的参保人员收住院或故意拖延出院、超范围检查等情况发生。 3、每月医保费用报表按时送审、费用结算及时。六、医疗保险政策宣传： 1、定期积极组织医务人员学习医保政策，及时传达和贯彻有关医保规定。 2、采取各种形式宣传教育，如设置宣传栏，发放宣传资料等。 经过对我院医保工作的进一步自查整改，使我院医保工作更加科学、合理，使我院医保管理人员和全体医务人员自身业务素质得到提高，加强了责任心，严防了医保资金不良流失，在社保局的支持和指导下，把我院的医疗工作做得更好。 2013年6月26日篇二：基本医疗保险管理自查报告 2011年度医疗保险工作自查报告 在社保局的
5、监督指导下，在院领导关心支持下，通过本院医保管理小组成员和全院职工的共同努力，各项医保工作和各种医保规章制度都日趋完善，步入正规，根据上级要求，院组织医保管理小组对2011年度的基本医保管理工作进行了全面的自查，现将自查工作情况作如下汇报： 一、医疗保险基础管理： 1、本院有分管领导和相关人员组成的基本医疗保险管理组织，并有专人具体负责基本医疗保险日常管理工作。 2、各项基本医疗保险制度健全，相关医保管理资料具全，并按规范管理存档。 3、医保管理小组定期组织人员分析本院门诊住院参保人员各种医疗费用使用情况，如发现问题及时给予解决，组织不定期的医保管理情况抽查中发现问题及时纠正。 4、医保管理小
6、组人员积极配合社保局对医疗服务价格和药品费用的监督、审核、及时提供需要查阅的医疗档案和有关资料。 二、医疗保险服务管理： 1、本院提倡优质服务，设施完整，方便参保人员就医。 2、药品、诊疗项目和医疗服务设施收费实行明码标价，并提供费用明细清单。 3、对就诊人员进行人卡证的身份验证，杜绝冒名就诊等现象。4、对就诊人员要求需用目录外药品、诊疗项目等事先都证求参保人员同意，并鉴定知情书。 5、严格按照医保标准填写门诊就诊登记和相关资料记录。 6、严格按药品监督部门的要求从正规渠道购进药品。 三、医疗保险业务管理： 1、严格执行基本医疗保险用药管理规定，严格执行医保用药审批制度。 2、按基本医疗保险目
7、录的要求储备药品 3、不定期抽查门诊处方、出院病历、检查配药情况严格按规定执行。 4、严格执行基本医疗保险诊疗项目管理规定。 5、严格执行基本医疗保险服务设施管理规定。 四、医疗保险信息管理： 1、本院信息管理系统能满足医保工作的需要，日常维护系统较完善，新政策出台或调整政策及时修改，能及时报告并积极排除医保信息系统故障，保证系统的正常运行。 2、对医保窗口工作人员加强医保政策学习，并强化操作技能。 3、本院医保信息系统数据安全完整准确。 五、医疗保险费用控制： 1、严格执行医疗收费标准和医疗保险限额规定。 2、每月医保费用报表按时送审，费用结算及时准确。 六、医疗保险政策宣传： 1、本院不定
8、期组织医务人员学习医保政策，及时传达和贯彻相关医保规定，并随时抽查医务人员对医保管理各项政策的掌握、理解程度。2、采取各种形式宣传医保法律法规政策教育，如设置宣传栏、发放宣传资料等。使工作人员及时准确了解相关法规政策 3.认真学习劳动保障报，及时了解医保新政策。 七、存在的问题 1、有部分大处方，这是由于我场居民居住分散，刷卡不便造成的，在今后的工作中加以改进。 2、门诊刷卡存在有个别处方不规范。 针对以上问题，今后我们要对患者做更加耐心，细致的解释工作，对医生进行严格要求，不定期学习严格按规章制度办事，确保医保工作正常有序开展，杜绝以上问题的发生。 。 2011年12月15日篇三：基本医疗保
9、险自查报告 基本医疗保险自查报告 在上级部门的正确领导下，我院严格遵守国家、省、市的有关医保法律、法规，认真执行医保政策。根据医保中心文件要求，认真自查，现将自查情况汇报如下： 一、高度重视，加强领导，完善医保管理责任体系 接到通知要求后，我院立即成立以主要领导为组长，以分管领导为副组长的自查领导小组，对照有关标准，查找不足，积极整改。我们知道基本医疗是社会保障体系的一个重要组成部分，深化基本医疗保险制度政策，是社会主义市场经济发展的必然要求，是保障职工基本医疗，提高职工健康水平的重要措施。我院历来高度重视医疗保险工作，成立专门的管理小组，健全管理制度，多次召开专题会议进行研究部署，定期对医师
10、进行医保培训。医保工作年初有计划，定期总结医保工作，分析参保患者的医疗及费用情况。 二、规范管理，实现医保服务标准化、制度化、规范化 几年来，在市劳动局及市医保处的正确领导及指导下，建立健全各项规章制度，如基本医疗保险转诊管理制度、住院流程、医疗保险工作制度、收费票据管理制度、门诊管理制度。设置“基本医疗保险政策宣传栏”和“投诉箱”；编印基本医疗保险宣传资料；公布咨询与投诉电话3827120；15282596120，热心为参保人员提供咨询服务，妥善处理参保患者的投诉。在医院显要位置公布医保就医流程、方便参保患者就医购药；设立医保患者挂号、结算等专用窗口。简化流程，提供便捷、优质的医疗服务。参保
11、职工就诊住院时严格进行身份识别，杜绝冒名就诊和冒名住院现象，制止挂名住院、分解住院。严格掌握病人收治、出入院及监护病房收治标准，贯彻因病施治原则，做到合理检查、合理治疗、合理用药；无伪造、更改病历现象。积极配合医保经办机构对诊疗过程及医疗费用进行监督、审核并及时提供需要查阅的医疗档案及有关资料。严格执行有关部门制定的收费标准，无自立项目收费或抬高收费标准。 加强医疗保险政策宣传，以科室为单位经常性组织学习了遂宁市职工医疗保险制度、四川省基本医疗保险甲、乙类药品及基本药品等文件，使每位医护人员更加熟悉目录，成为医保政策的宣传者、讲解者、执行者。医院设专人对门诊和住院病人实行电话回访，回访率81.
12、4，对服务质量满意率98，受到了广大参保人的好评。 三、强化管理，为参保人员就医提供质量保证 一是严格执行诊疗护理常规和技术操作规程。认真落实首诊医师负责制度、三级医师查房制度、交接班制度、疑难、危重、死亡病例讨论制度、术前讨论制度、病历书写制度、会诊制度、手术分级管理制度、技术准入制度等医疗核心制度。二是在强化核心制度落实的基础上，注重医疗质量的提高和持续改进。普遍健全完善了医疗质量管理控制体系、考核评价体系及激励约束机制，实行院、科、组三级医疗质量管理责任制，把医疗质量管理目标层层分解，责任到人，将检查、监督关口前移，深入到临床一线及时发现、解决医疗工作中存在的问题和隐患。规范早交接班、主
13、任查房及病例讨论等流程。重新规范了医师的处方权，为加强手术安全风险控制，认真组织了手术资格准入考核考试，对参加手术人员进行了理论考试和手术观摩。三是员工熟记核心医疗制度，并在实际的临床工作中严格执行。积极学习先进的医学知识，提高自身的专业技术水平，提高医疗质量，为患者服好务，同时加强人文知识和礼仪知识的学习和培养，增强自身的沟通技巧。四是把医疗文书当作控制医疗质量和防范医疗纠纷的一个重要环节来抓。对住院病历进行评分，科主任审核初评，医院质控再次审核。同时积极开展病历质量检查和评比活动，病历质量和运行得到了有效监控，医疗质量有了显著提高。五是强化安全意识，医患关系日趋和谐。我院不断加强医疗安全教
14、育，提高质量责任意识，规范医疗操作规程，建立健全医患沟通制度，采取多种方式加强与病人的交流，耐心细致地向病人交待或解释病情。慎于术前，精于术中，严于术后。进一步优化服务流程，方便病人就医。通过调整科室布局，增加服务窗口，简化就医环节，缩短病人等候时间。门诊大厅设立导医咨询台，配备饮水、电话、轮椅等服务设施。设立门诊总服务台为病人提供信息指导和就医服务，及时解决病人就诊时遇到的各种困难。实行导医服务、陪诊服务和首诊负责制，规范服务用语，加强护理礼仪的培训，杜绝生、冷、硬、顶、推现象。加强妇科门诊的私密性，合理安排患者就诊，实行一医一患一诊室，充分保护患者的隐私，使得诊疗活动更加人性化、舒适化。重
15、视细节服务，对来门诊就诊的陪人一天两次免费发放冷饮和热饮，中午就餐时间，为做治疗的患者和陪人免费发放面包。多年来一直实行住院病人免费发小米稀饭，对患者护理服务热心，护理细心，操作精心，解答耐心。由经验丰富的产科、儿科护理专家组成的产后访视队，对出院的产妇和新生儿进行健康宣教与指导，得到产妇及家属的高度赞扬。通过一系列的用心服务，客服部在定期进行病人满意度调查中，病人满意度一直在95%以上。 四、加强住院管理，规范了住院程序及收费结算 为了加强医疗保险工作规范化管理，使医疗保险各项政策规定得到全面落实，根据市医保部门的要求，病房采用了医疗保险参保病人专用绿色床头卡，病历盖医保专用章。经治医师均做
16、到因病施治，合理检查，合理用药。强化病历质量管理，严格执行首诊医师负责制，规范临床用药，经治医师要根据临床需要和医保政策规定，自觉使用安全有效，价格合理的药品目录内的药品。因病情确需使用药品目录外的自费药品，特定药品，“乙类”药品以及需自负部分费用的医用材料和有关自费项目，经治医师要向参保人讲明理由，并填写了“知情同意书”，经患者或其家属同意签字后附在住院病历上，目录外服务项目费用占总费用的比例控制在15%以下。 五、严格执行省、市物价部门的收费标准 医疗费用是参保病人另一关注的焦点。我院坚持费用清单制度，每日费用发给病人，让病人签字后才能转给收费处，让参保人明明白白消费。 桂花中心卫生院 2
17、011年5月10日organization system and working mode, the selection of a number of municipal strengthening group to build innovation and strengthen the organization of the basic level organizations advanced model.(seven) the manual work of the Communist Youth League Organization published and League branch
18、 of manual work, to promote the use of two manuals in the citys organizations at various levels. The county committee, directly under the group (work) is under the jurisdiction of grassroots League and group (total) using branch ratio shall not be less than 70%.Three, to further strengthen the group
19、s leadership and team building(a) to strengthen the leagues leadership at all levels of construction. Continue to do a good job of municipal Party Committee Organization Department on the strengthening of the Communist Youth League cadres management opinions implementation. To promote the group coun
20、ties (autonomous counties, cities) Commission and city directly under the group (workers) appointed to carry out the Five team building activities. Improve the League Association Department working mechanism. Conscientiously fulfill the duties of CO, combined with the city group directly under (the)
21、 Committee of the general election and the adjustment, actively jointly with the unit where the party organization department good group leadership selection with the work. Do a good job in municipal Party committee assistant committee leadership and leading cadres of the annual assessment work, adh
22、ere to and improve the assistant secretary of the Communist Youth League talk system group To weave individual conversation and collective conversation, to strengthen the committees of all levels, the Standing Committee of the Standing Committee, the establishment of a sound system of central group
23、learning, the system of investigation and study, the system of important issues and the reporting system.(two) to strengthen the work of education and training of cadres to conscientiously implement the Central Committee. On the implementation of grassroots cadres training project and opinions on ca
24、rrying out the mission municipal CYL Cadres training project implementation opinions, full implementation of the project of the City Youth League cadres training education. Focus on the county grassroots cadres and workers focused on training, the new school system vocational training League cadres,
25、 for the Municipal Organization Department jointly held the third session of the Communist Youth League system training cadres in party. Focusing on the construction of new socialist countryside, strengthening village cadres and rural construction team group member of the young team, the county orga
26、nizations at various levels throughout the year is expected to train 100 00 rural grassroots cadres, plans to train 1000 village secretary of the village Party branch.(three) actively promote grassroots cadres election work. Under the unified leadership of the party organization, to strengthen grass
27、roots organizations direct work, standardize the election work rules and procedures, in the designated candidate, open competition to democratically elected branch secretary at the same time, actively and steadily the development of Township, streets and other grassroots organizations in the direct
28、election of the pilot work, on the basis of summarizing the experience and gradually expand the scope of the pilot, and gradually formed a set of measures and cadres election system.(four) to strengthen the cadres testing exercise. To study the development of XX city from 2006 to 2008 cadres testing
29、 exercise planning. To select outstanding cadres to the central mission in Beijing, Shanghai, Guangzhou and other central organs and sending work in developed areas. With the Central Committee the implementation of the western region and ethnic minorities cadres training plan . To carry out the eigh
30、th batch of municipal organs attachment cadre management, selection, training work. The outstanding cadres to start the National Development Bank XX branch testing exercise.(five) to strengthen the group construction. The main position to play the role of Youth League cadre education and training as
31、 the city, in accordance with the requirements of post training, further curriculum scientifically and rationally, adopt arrangement menu course, basic theory includes group work, focus, hot and difficult issues, to enhance the content and practice; to strengthen the construction of teaching staff,
32、the integration of teachers, establish a quality teacher training team, establish and implement course evaluation system; take delivery of training to the countryside, on-site training, and increase the rural grassroots cadres training efforts.Four, efforts to strengthen the work of young talent(a)
33、to tenth XX young 54 medal in recognition of the publicity, and actively explore the XX youth service. 54 Medal of institutionalization, standardization and socialization mechanism. Give full play to the XX award in recognition of 54 youth medal Association, Youth Award winner in the 54 chapter, inv
34、estigation activities. Who won the Youth Service medal, dedication to the society to create conditions, build the stage. During the 54, named in recognition of the tenth XX young 54 medal. The association of XX editing of young talent , the exchange of information and communication platform for the
35、XX of outstanding young talents.(two) the establishment of municipal Party committee of young talent information database. In accordance with the feasible, effective, classification management, implement step by step principle, the establishment of municipal Party committee of youth talent database;
36、 guiding organizations at various levels generally established the young talent database, construction of city, county (directly under the Communist Youth League), grassroots organizations three young talent information database the relevant information collection system, and gradually establish the
37、 citys young people, the Communist Youth League youth talent information network, provide information platform for young talent resource development.Five, take effective measures to strengthen the mission management(a) to strengthen the mission management work. Strengthen the dues collection and man
38、agement, continue to adhere to the dues collection regularly reporting system, the annual comprehensive award in recognition of the tour and the tour one vote veto system audit system. Do statistical work in the group. The group service award in recognition of the advanced units, standardization, pr
39、omoting group management work institutionalized.(two) to strengthen the organization of research and information exchange efforts. Grassroots carry out research, efforts to form a number of theoretical results. Make full use of the network carrier, to explore the establishment of electronic group se
40、rvice system, promote the work of Communist Youth League information.Attachment 4:XX municipal Party Committee Propaganda Department of the Communist Youth League work pointsIn 2006, the Communist Youth League propaganda ideological work XX to Deng Xiaoping theory and the important thought of Three
41、Represents as guidance, study and implement the partys sixteen and the spirit of the the fifth Plenary Session of the 16th CPC Central Committee implementation of the eight plenary session of the two committee, the citys cultural work conference, the Propaganda Department of the meeting and the the
42、fourth Plenary Session of the 15th CPC Central Committee permanent mission spirit, closely around 11th Five-Year XX the goal of full implementation of Scientific Outlook on Development, emancipating the mind, seeking truth from facts, keep pace with the times, close to reality, close to life, close
43、to the young, persevere grasp orientation, grasping deepening, grasping construction innovation, further improve the groups propaganda and ideological work ability, unity To guide the majority of members of the youth to achieve the 11th Five-Year planning tasks, the overall construction of a well-of
44、f society, building a socialist harmonious society to make new contributions.One, adhere to the Three Represents important thought and Scientific Outlook on Development education to guide the youth, to further strengthen the ideological and political education of youth(a) armed with youth science th
45、eory. Unremittingly with Deng Xiaoping theory and the important thought of Three Represents armed members of youth education, to promote the study and implement to expand the depth and breadth. To study and implement the important thought of Three Represents with the establishment and implementation
46、 of Scientific Outlook on Development combine with the implementation of the requirements of constructing socialist harmonious society with Scientific Outlook on Development, carry out education as an important part of the theory of armed youth in the new period, strengthen the establishment and imp
47、lementation of Scientific Outlook on Development education, educate and guide the youth to fully understand the great significance of establishment and implementation of Scientific Outlook on Development, in-depth understanding of the Scientific Outlook on Development era back The king, the practice
48、 foundation, basic connotation, historical status, spirit and practice requirements, a profound understanding of Scientific Outlook on Development with Marxism Leninism, Mao Zedong thought, inheriting and developing relationship between Deng Xiaoping theory and the important thought of Three Represe
49、nts, to help young people establish and consciously practice Scientific Outlook on Development. Persist in learning, grasping the backbone, grasp the practice, grasp the opportunity. Catch club, effective way to grasp the network, with the group of cadres, young students and young backbone fronts as the focus, to promote the work of the
