4 initiatives to make health insurance long-term management in the window "ground to take root"

Wind construction is the window unit often make unremitting efforts, Shanghai Jing'an District Medical Insurance Affairs Center (hereinafter referred to as "Jing'an Medical Insurance Center") in accordance with the requirements of the State Health Security Administration's wind construction work, will continue to improve the work style, and constantly improve the level of service as an important task to catch.
2020, Jing'an Medical Insurance Center mainly starts with how to establish and improve the long-term management mechanism of the wind construction, and adopts four measures to make the long-term management take root in the window.
Implementation of "careful and thoughtful" epidemic prevention service measures at the beginning of this year, in the face of the sudden outbreak of new crown pneumonia, Jing'an Medical Insurance Center to strengthen the service hall epidemic prevention and control management, strengthen staff safety education, the introduction of "protection measures 11" to ensure that the epidemic prevention work to do a detailed reality.
Optimize the process of medical insurance operations during the epidemic prevention and control, around the "grasp key links, keep a close eye on weak links, reduce liquidity, find risk points, control the source of infection as a top priority" requirements, in the hall to place Irabao, publicity "one network to do", "with the bid", encourage and guide the insured personnel through the "online", "hand-held" business, reduce the number of people running.
the strict implementation of the service hall epidemic prevention measures and the implementation of party members demonstration posts, service standard soldiers, satisfactory window, quality service brand and other competitive activities combined.
asked everyone to serve the masses through masks, but the service standards can not be lowered, service enthusiasm can not be weakened.
, Jing'an Medical Insurance Center completed window hardware, software upgrades, improve the call queuing system.
In each window set up inside and outside the double screen, the external screen for the masses to provide service guide reminders, good and poor evaluation feedback and other matters, the internal screen for employees to add operating guide, business volume statistics and other functions, this initiative has been widely praised by the masses and workers.
to create a window to accept version 2.0 to improve the effectiveness of the operation.
In order to further promote the Yangtze River Delta health insurance interconnection, improve the satisfaction of off-the-ground insured personnel, the central window from the original city and off-the-ground business separately accepted, upgraded to the city and off-the-ground business to accept, greatly improve the efficiency of off-the-go reimbursement, shorten the waiting time for off-the-ground insured personnel, but also effectively solve the problem of window busy and busy.
april this year, Wang Zugen, a retired employee of the Shanghai Railway Bureau, sent Jinqi to express his gratitude to the staff of Jing'an Medical Insurance Center for "considering the off-site policy and solving problems for the people".
In accordance with the relevant work requirements of the Municipal Medical Insurance Bureau and the Municipal Medical Insurance Center, complete the pilot work of medical institutions to register directly for outpatient major illnesses in Jing'an District, and by the end of May, 17 hospitals in the region had completed a total of 7639 outpatient major diseases registrations, achieving "zero materials, zero running" for this business in the region.
To promote the implementation of the "special group medical expenses subsidy work" in the region, with the district civil affairs bureau, district education bureau, district decommissioning bureau, district general trade union cooperation, the development of jing'an district special group medical expenses subsidy platform, make full use of information technology, change the original by the preferential care object to provide their own materials to the window application model, to the platform data automatic accounting, the new model of generating reimbursement results data.
present, the four categories of people who care for the staff, the administrative staff, civil servants and the employees of the education system have been included in the platform management, and the relevant personnel data and medical insurance data have entered the trial operation, covering nearly 35,000 people.
initial realization of the relevant service object medical expenses subsidies in the region "zero application, zero materials, zero running."
Cultivate a model-led atmosphere of "first-in-class competition" around the "new functions, new business" in-depth promotion of business training normal work, according to business requirements and practical work, regularly held on the second Tuesday of each month for business learning, business exchanges and business discussions for the purpose of training sessions, by the relevant business responsible comrades to take turns teaching, enhance the professional ability of cadres.
This party members" four talk four have" standards into the window unit service standardization of the actual work, to the city 38 red flag bearer Yan Rudan, fighting in the airport anti-epidemic front-line workers Hu Chenbin, Liu Jiaqing, support Pengpu Town anti-epidemic work Chen Qi, Zhao Jun, Qian Jing as an example, actively promote the good party members around the advanced deeds of good cadres, guide the vast number of workers in their posts to play a role, build a successful career, improve the level of service for the people.
organizations to open window civilization demonstration posts, monthly by various departments to arrange personnel to the window rotation, and continue to promote the "people-oriented, innovative, effective" window brand building.
promote the "bottom-up" continuous improvement mechanism Jing'an Health Insurance Center to encourage "bottom-up" workers to make suggestions, play collective wisdom.
through the window monthly meeting, political style advice and other activities, found the bottleneck problems encountered in the work, widely solicited the staff's improvement opinions.
with the pilot of electronic invoices this year, how to eliminate duplicate reimbursement in the case of improved efficiency is our new problem.
front-line staff on the window on the proposal to identify the electronic invoice by scanning the gun QR code, withdrawal of invoice number, invoice amount and other information.
After communication and coordination with technology companies has initially completed the program development, in May this year Jing'an medical insurance electronic fee bill management system officially launched, in Ningbo, Yangzhou, Zhenjiang off-the-go commissioned reimbursement business pilot.
through this system, we have reduced the window entry invoice process, improved the efficiency and accuracy of business operations, effectively avoided the problem of repeated reimbursement of electronic invoices, and effectively maintained the security of the health insurance fund.
To create a new situation of "people-centered" letter-and-visit work since the institutional reform in 2018, Jing'an Medical Insurance Center adheres to the "people-centered", the letter-and-visit work as an important work to understand the people's feelings, concentrate people's wisdom, safeguard the people's interests, rally the people's hearts, do everything possible to solve problems for the masses, and effectively make the letter-and-visit work to the hearts and minds of the masses.
From 2018 to the present, Jing'an Medical Insurance Center has handled 192 letters and visits of all kinds, and the satisfaction rate of the masses has reached 100%, so that "everything has an account, pieces have fallen, everything has an echo", and strive to eliminate all kinds of stability hidden dangers.
in all kinds of letters and visits, the long-term insurance letter and visit contradiction is the most prominent.
Jing'an Medical Insurance Center community business department head Yan Donghui has always practiced the "people-oriented, sincere" purposes, carefully receive every visiting masses, patiently answer every consultation phone call, with heart, change of position thinking, with excellent business skills and excellent communication skills, to resolve one letter after another contradictions.
2019, an elderly disabled man wrote a letter complaining that the care home had replaced the carer because he was disabled and sold badly.
Yan Donghui communicated with the nursing station in a timely manner and went door-to-door with the head of the care station to explain to the elderly that the replacement of carers was to provide better service to the elderly and did not dissogate him.
old man's face finally burst into a smile.
Jing'an Medical Insurance Center always adhere to the interests of the masses no small matter, wholeheartedly serve the people, with the spring weathered rain-like work, warm the hearts of every petitioner.
the original title: four initiatives to achieve long-term management of the construction of the wind - Jing'an Medical Insurance Center wind construction features highlights.