National health and family planning commission, ministry of finance about do a good job in the new rural cooperative medical treatment across the province medical expenses and verification and offer the guidance work 
 
  
The 2015-02-27 national health and population and family planning commission of the People's Republic of China 

Who hair [2015] no. 46 at the grass-roots level 

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission, finance bureaus:
 
    For the implementation of the general office of the state council concerning the deepening medical and health system reform in 2014, the key task of notice (countries do hair [2014] no. 24) the relevant requirements, optimization of ginseng to farmers across the province for medical treatment cost and process, improve the new rural cooperative medical management services (hereinafter referred to as the new farming match) level, the health rights and interests of maintenance, do it right now, the new farmers across the province medical expenses for verification and to work puts forward the following guidelines:
 
    A, objectives and principles
 
    (a) the main target
 
    In order to maintain the interest of the ginseng to peasants as the basis, by means of informationization, optimize service process, improve the coordination mechanism, improve new farming provinces by verification and submitted to the management and service level and efficiency, maintenance fund safety, convenient to the masses, the gradual implement new agricultural provinces by verification and directly. In 2015, select the section as a whole the area and the medical establishment that decide a dot, relying on the nation's new farming information platform to carry out the cross check and knot to pilot province for medical treatment expense; In 2016, the national provinces by the verification mechanism is preliminarily established, across to further expand the scope of a province for medical treatment and reported to the pilot; In 2018, the basic realization across most of the provinces, autonomous regions and municipalities directly under the provincial medical expenses verification, across the province for medical treatment and work to further advance; In 2020, the most of the provinces (autonomous regions and municipalities) will work in the medical establishment that decide a dot with appropriate conditions across provinces junction directly go to a doctor.
 
    (2) the basic principles
 
    1. Adhere to the people-oriented, convenient and beneficial, for the people. In line with people-oriented, highly responsible spirit, carry across the province medical service ginseng to the masses as cost verification and knot work starting point and the foothold, simplify the procedure, standard system, to service the masses to provide quality, efficient and convenient services.
 
    2. To establish a mechanism, form a long-term. To develop new farming provinces by verification and knot at work, the key is to build the mechanism. At all levels should establish and improve the new farmers with orgnaization of agency of medical establishment that decide a dot, between different parts of the different level of new farmers in the collaborative mechanism between information platform and information exchange mechanism, achieve cross-regional medical information sharing of the Internet.
 
    3. The pilot, pushed steadily. Across the province for medical treatment cost verification and knot at work, should be with the current new agricultural informatization construction level and ginseng to the masses will practical combination, such as summing up experience through pilot, gradually opened.
 
    Second, actively carry out across the province by the verification
 
    (3) to establish a national and provincial cross-province medical expenses information database
 
    Information platform of new farmers in the country and establish a nationwide service patients across the province by information database (hereinafter referred to as the national library). Passed the provincial new farming and the national library data collected across the province medical information platform, information storage across the province for medical treatment cost, fixed-point medical institutions and agencies at all levels, administrative division code dictionary directories and cost check application form, reply information management class data. At the same time regularly to provincial new agricultural information platform to push related data.
 
    The provinces (autonomous regions and municipalities) built based on a new farming in the region information platform, the province (area, city) ginseng to patients across the province by information database (hereinafter referred to as the provincial library). Library is mainly responsible for collecting the secondary in the province at the provincial level (including, similarly hereinafter) above the medical establishment that decide a dot accepts, fujian association of foreign languages and was hospitalized cost information, and regularly submitted to the national library. Provincial library also received national library to push patients to the province of fujian association of foreign languages and information on medical institutions for medical treatment.
 
    (4) improve the provinces by information collection and exchange mechanism
 
    Across the province for medical treatment cost of information acquisition. Second class above the medical establishment that decide a dot is responsible for the collection of this institution accepts data from other provinces was hospitalized, according to the basic data set part 10: electronic medical record in hospital medical record home page "exchange content (WS445.10-2014) is generated. Temporarily do not have conditions to generate the hospital medical record home page format, according to the national unicom technology information platform of the new rural cooperative medical scheme (try out) "(who do farmers who letter [2013] no. 456) exchange format to generate the content, the information platform of new farming and at the same level or directly uploaded to the local provincial library. Such as medical institutions province (area, city) regional health information platform, data quality is better and can update, provincial new farming and regional health information platform information platform can be directly call interface, generate provincial library.
 
    National new agricultural information platform and the provincial agricultural information platform of unicom and data exchange. Make use of the information platform of nation's new farming and provincial new agricultural information platform, the provincial agricultural information platform and the second class above the medical establishment that decide a dot in the province has established the network infrastructure, in accordance with the principle of local administrator, the provinces (autonomous regions and municipalities) shall discharge from hospital to the region within 1 week 2 above departments of provincial medical institutions was hospitalized information uploaded to the national library. National new farming and information platform will across the province medical patient information push service to patients of provinces, autonomous regions and municipalities directly under the provincial new farming and information platform, push 1 times a week at least. Provincial new farming and receive regular information platform of the cost of the nation's new farming information platform forward check application form, and reply after receiving the application form within 1 week.
 
    (5) establish a query cooperation mechanism
 
    Orgnaization of agency of farmers as a whole the area new login by local provincial library or national library for cost check; If not query to the relevant information, submit to the nation's new farming information platform for inspection application form and forwarded by the nation's new farming information platform to go to a doctor to new farming and information platform for verification at the provincial level; If still not query to the relevant information, may take artificial way for verification. Encouragement in the form of purchasing service will be commissioned by artificial inspections to third-party institutions such as insurance companies, improve the efficiency of inspections and the degree of specialization.
 
    Nation's new farming information platform will also by unicom with all kinds of information system, to expand the query the coverage of medical institutions. Encourage conditional form such as medical institutions through the portal to provide patients with medical expenses authenticity query. Patients go to a doctor of the medical establishment that decide a dot is not covered national new farming and information platform, and go to a doctor to new farming agencies and medical institutions dealing with medical expenses trans-provincial inspections to provide necessary assistance.
 
    Three, yet prudently proceed with work of across the province for medical treatment and quote
 
    (6) gradually unified the province medical compensation policy
 
    The provinces, autonomous regions and municipalities directly under the family planning administrative department of public health to gradually unified the province (area, city) ginseng patients medical treatment compensation scheme, outside the province to establish a unified drug directory, diagnosis and treatment projects, and medical service information standard library, norms and orgnaization of cross-regional medical related process and junction method. Farmers across the province for medical treatment in patients with new treatment to the execution of a ginseng to reimbursement policy or by orgnaization of agency of ginseng to reach an agreement after consultation with the medical establishment that decide a dot to perform medical reimbursement directory, fu biao, pay scale and pay limitation still perform accounting rules.
 
    (7) to carry out the classification system of referral
 
    New farmers across the province medical expenses for verification and knot at work to combined with hierarchical diagnosis and treatment of efforts to promote. The region as a whole to gradually establish a long-distance medical BaoBeiZhi degrees. Qualified accounting for patients after a ginseng to referral for the record to the province for medical treatment, ginseng to orgnaization of agency of should be sent to the related information in time at the provincial level new agricultural information platform and the national agricultural information platform. The medical establishment that decide a dot new agricultural information platform referral data according to the country, receiving patients in the hospital, and hospital discharge settlement and submitted to the service for the referral of patients.
 
    Encourage the establishment of a provincial settlement platform (eight)
 
    Everywhere are encouraged to establish provincial new farming settlement platform, unified handling and coordination in the province and across the province medical cost check, and submitted to the job. Can entrust insurance companies and other third parties establish settlement platform at the provincial level, and compensation in the form of purchasing service; The current stage, can also be a ginseng to agencies and the medical establishment that decide a dot sign directly way to establish a point-to-point settlement channels.
 
    (9) specification and settlement process
 
    Already dealt with the referral service to provide patients with direct settlement services of the medical establishment that decide a dot, discharge settlement only pay some conceit, new farming and fund compensation part by the medical establishment that decide a dot the advance payment. The medical establishment that decide a dot on a regular basis to related information submitted to the local provincial settlement platform; Go to a doctor to new farming and settlement platform and the medical institutions at the provincial level regularly settlement payment of compensation funds, again on a regular basis and ginseng to provincial settlement platform to carry out the liquidation. Temporarily does not have the conditions of region, but by the medical establishment that decide a dot ginseng to orgnaization of agency of direct settlement with the patient.
 
    Informationization foundation is weak, the accounting agencies shall provide different reimbursement service, ginseng to farmers in the province after medical institutions for medical treatment, expense vouchers and other information provided to orgnaization of agency of ginseng, agencies through the national new farming information platform to provide medical data check, after confirmed the reimbursement amount calculated on the basis of the local compensation plan, and remit the compensation fees directly to the accounting personnel's bank account. Residents health card popularity of the region, can give full play to the residents' health card financial function, optimize across the province for medical treatment and submitted to the process.
 
    Fourth, safeguard measures
 
    (10) of the management services across the province medical patients
 
    Farmers as a whole the area new agencies shall, according to migrant workers across the province, different referral, emergency personnel etc. The characteristics of different groups, to carry out the management responsibility, strengthen the supervision of medical services and management services across the province medical patients. Combined with the classification system of diagnosis and treatment methods and referral referrals, to improve the procedures of different ground treatment for the record, and convenient for ginseng to patients to new farming and submitted to the service. Doctor to orgnaization of agency of new farming and shall assist the ginseng to identity verification information registration, patients, medical services, medical expenses authenticity review, etc.
 
    Enhance the level of long-distance medical information (11)
 
    Improve the nation's new farming information platform construction, the standard of new farmers and identification procedures, promote residents health card in new farming and the integrated application of information system, promote the fixed-point medical institutions at all levels and new farming the connectivity information platform. Establish and improve the national and provincial new farming provinces by verification and knot system, standardize business processes, system interface and information transfer standard, etc., to lay a good foundation for medical information data transmission across the province; Accelerate the country's new agricultural information platform and all provincial new farming and information platform, through the perfect efficient means of information technology provides cross province medical cost verification and direct service.
 
    (12) to ensure information security
 
    Family planning administrative department of public health at all levels, new farming and orgnaization of agency of medical establishment that decide a dot, should pay attention to information security and privacy protection across the province medical patients work, according to state information security protection system and released by the national health and family planning commission, the population health information management measure (trial) "requirements, formulate safety management system, operational procedures and technical specifications, to protect information security and patient privacy.
 
    Five, the organization carries out the
 
    (13) to strengthen overall coordination
 
    The family planning administrative department of public health at all levels be responsible for the verification and long-distance medical expenses and to coordinate work. Provincial family planning administrative department of public health should be in accordance with the unified state requirements, coordinate relevant departments to formulate the region across the province for medical treatment cost verification and knot work plan, clear assist provincial new farming and other agencies in provinces by the verification of the cooperation mechanism, and be submitted to the national health and family planning commission for the record. To further improve the fund financial management system, supervise and urge as a whole the area allocated to the payment of the medical establishment that decide a dot trans-provincial funds in a timely manner. Strengthen the communication with other provinces (autonomous regions and municipalities), and actively promote inter-provincial long-distance medical treatment at work. Farmers as a whole the area new orgnaization of department of management and to clarify responsibilities, set with "ginseng to farmers" as the core of the full service concept, to plan as a whole area inside and outside all ginseng to patients to provide new farming and management services.
 
    Clear the responsibility of the medical establishment that decide a dot (14)
 
    The medical establishment that decide a dot to take measures to improve medical service quality, control the unreasonable expenses, perfecting the system of measures, prevent farmers set of diddle new funds, etc. Timely and complete records of cross-provincial hospitalized patients with relevant information, and the related information on a regular basis as requested to submit to the local provincial library. The new farming and agencies at various levels shall take measures to strengthen the regulation of province outside the medical establishment that decide a dot, the medical establishment that decide a dot to cooperation across the province by the verification and qualification of evaluation.
 
    (15) to strengthen the propaganda guidance
 
    Vigorously promote to take advantage of a variety of forms, for the ginseng to farmers to understand cross-province medical cost verification and knot work policies and practices, actively cooperate with hierarchical diagnosis and treatment of the implementation of the system. At the same time pay attention to the information, a reasonable guide social expectations.
 
    New farmers across the province medical expenses for verification and ginseng to masses at work is a matter of vital interests, is the important of equal basic public services, and is the inevitable requirement of perfecting the construction of new farming and system. All relevant departments should attach great importance to and work closely, ensure the cross-regional medical cost verification and knot fine do real work, promote the new farming system healthy and continuous development. 

National health and family planning commission the ministry of finance
 
On January 9, 2015