I HC Y DC TP.

HCM
BNH VIN I HC Y DC
S: 35 /QTr-BVHYD

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc
Thnh ph H Ch Minh, ngy 19 thng 12 nm 2014

QUY TRNH
V vic cung ng thuc i vi bnh nhn
c th BHYT khm bnh ngoi tr
I. Mc ch
-

m bo cung ng thuc p ng nhu cu khm cha bnh ngoi tr i

vi trng hp ngi bnh c th BHYT.

m bo thc hin ng quy nh v qun l, cung cp thuc ca BHYT

v ca Bnh vin.

II. Cc t vit tt

III.

BHXH TPHCM

: Bo him x hi Thnh ph H Ch Minh.

KD

: Khoa Dc.

NT

: Nh thuc

: Hp ng

KQ

: Kt qu

BHYT

: Bo him y t.

NB

: Ngi bnh

i tng - Phm vi p dng

Nh thuc B Nh thuc cp pht thuc cho NB c th BHYT khm v iu
tr ngoi tr.
Kho Chnh Khoa Dc
Kho Nh thuc

IV.

Lc

Thuc nhp theo H cung ng ca NT

Thuc nhp theo kt qu u thu cua BV

KHO NH THUC

KHO CHNH KD

Kho l cung cp thuc khng BHYT

Kho l cung cp thuc BHYT ngoi

Khotr
l cp pht ni tr

NH THUC B
p dng theo thng t 15/2011/TT-BYT

Theo gi BHYT ph duyt

Toa thuc c thanh ton BHYT:

Thuc c BHYT
Toa thuc khng c thanh ton BHYT
Thuc khng c BHYT

V.
-

VI.
-

Quy trnh
Bc 1: Nhp thuc
Kho Nh thuc: nhp thuc khng c thanh ton BHYT theo hp ng
cung ng ca Nh thuc.
Kho chnh ca Khoa Dc: nhp thuc c thanh ton BHYT theo Hp
ng cung ng da trn kt qu u thu ca Bnh vin.
Bc 2: Nh thuc B nhp thuc
Thuc khng BHYT t kho ca Nh thuc.
Thuc BHYT t kho chnh ca Khoa Dc.
Bc 3: Nh thuc cung cp
Thuc BHYT vi gi BHYT ph duyt t ngun thuc nhn t kho chnh
ca khoa Dc.
Thuc khng BHYT vi gi bn p dng theo hng dn ca Thng t s
15/2011/TT-BYT t ngun thuc nhn t kho ca Nh thuc.
Quy nh:
Cc trng hp hon tr v Kho chnh ca khoa Dc t Nh thuc B:
Thuc chm lun chuyn 60 ngy lin tc sau khi thng bo ngh
nh cung cp v khoa khm bnh lu s dng trong vng 30 ngy.
Thuc chm lun chuyn 30 ngy lin tc v thi hn s dng cn
trong vng 90 ngy.
Thuc c cng vn thu hi ca c quan qun l nh nc.
Thuc do bnh nhn hon tr do li cht lng ca nh sn xut.
Cc trng hp hon tr khc s c thc hin theo ng Quy nh hon
tr thuc ti Nh thuc.
Khoa Dc chu trch nhim theo di v bo co xut, nhp, tn Kho chn
thuc BHYT cp pht cho bnh nhn ngoi tr.
Nh thuc chu trch nhim theo di v bo co xut, nhp, tn Kho l
thuc BHYT cp pht cho bnh nhn ngoi tr.

Quy trnh ny c hiu lc k t ngy k.

KT. GIM C
PH GIM C
Ni nhn:
- Ban Gim c (bo co)
-

Cc KD, Nh thuc, P. CNTT (thc hin);

Phng TCKT

Lu: VT, Khoa.

( k)

Trng Quang Bnh