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Core Tip
Medicare funds are saving money people, is directly related to the vital interests of the majority of the insured person's health and life safety, this country has a strict management system. However, in mid-August of this year, an insider told this repeatedly reflected Xi'an Railway Hospital suspected of using special tools to handle false hospitalization, taking railway workers health insurance funds, four years involving nearly 20 million yuan of funds!
According to the reporter insider tip lines provided, from August 15, on suspicion of taking this shocking incident Medicare, which lasted more than three months of investigation conducted.
Phenomenon
Patients hospitalized patients seen
August 13,http://www.center-boki.com, 2010 to the 15th, Xi'an Railway Hospital have admitted five patients, respectively, outside the three inpatient department bears a constant ×, 4 × Zhu Qi, Wang × 7 sea,http://www.marineelectronicsjournal.com/how_to_buy.cgi, 8 Lee Health and Liu × 13 × Juan. However, according to the nurses to reflect that five patients from the hospital since they almost never seen one. Inpatient treatment but did not see the patient, how is this going?
August 16, 2010, this reporter went to three subjects outside Xi'an Railway Hospital inpatient wards One, this is a three wards, to see a bear × constant bed bedding neatly, does not put anything on the nightstand, I have not seen the patient or other accompanying relatives. Reporter to ask the patient next to two of a patient's condition, the other answer from him play live in, have not seen a people lived.
Reporters went to the 2nd ward, found Zhu Qi lived × 4 bed is empty, according to the patient's next bed accompanying relatives say that his relatives from staying in the ward since early August, have never seen this patient . The other three patients, namely 7 × Wang Hai, Li case 8 students and 13 × × Liu Juan, with the previous two "empty bed patient" the same.
Reporters asked the name of the patient's relatives and friends outside the three nurses on duty that day: "how not seen a patient bear × Heng?" The nurse replied that she only knew the patient has hospitalized but is never seen in this patient.
During the investigation, every 2-3 days, reporters will receive insider information to reflect the new false patient. As of October 22, insiders say, within these two months,louboutin, three subjects outside the hospital "hanging bed" when the patient reaches a maximum of 9 people.
As of October 25, the reporter rough statistics showed that a total of nearly 20 people a false hospitalized nine times during this reporter to the hospital for insider said patients were verified false,scarpe hogan uomo prezzi, were found in the case of hospitalization but not people, but from duty nurses and other patients at the verification of the insider information provided.
How the hospital is there such a strange phenomenon? According to insiders say, these patients actually do not exist, they are "fake patient." Inpatient hospital rely on this false form of suspected taking Medicare funds.
When insiders told reporters on an amazing burst of two numbers: 4 years, nearly 20 million yuan! According to him, Xi'an Railway Hospital since 2007, on suspicion of illegal taking of Medicare funds 1974 million yuan.
Broke
Four years on suspicion of hedging amounted to nearly 20 million yuan
The insiders say,sito moncler ufficiale, during his tenure at the hospital, due to work, the unit will continually receive some workers and associated personnel departments reflect some familiar with the matter, in order to fabricate false cases exist in the form of cash in the hospital medical insurance funds do have Five of six continuous years, and a huge number. He was shocked to hear, at first could not believe. Understanding of the situation began to ask whether it is true, as reflected in this period, he also continued to receive reports of a lot of writing materials explicitly mentioned in the material are suspected of involvement in multiple hospital departments hedging.
To reflect some of his staff said that this situation is very terrible, they also had to reflect over the House leadership, but did not get enough attention, and even rebuked by individual leaders.
In order to find out the truth, the informant specifically to find an important understanding of the department director is involved in the case, in January-July 2009, the department director to submit the income statement, we found the staff to report these financial figures and letters consistent with the situation said. He tried to understand the specific circumstances, but encountered great resistance.
After June 2010, suspected of taking someone reported the existence of the Medicare hospital funding to higher authorities, higher authorities had set up an investigation group to the hospital to investigate, but ultimately did not detect any major problems. This matter hedging had some impact, there is a period of time, basically stopped, but the wind is over, and restore the original condition.
During the investigation, much of what has been the impact? The insider told reporters in the material provided, the amount of health insurance funds allegedly taking part showed only 2010 1-10 months, Xi'an Railway Hospital on suspicion of taking Medicare funds amounted to 4.218 million yuan (this number inpatient hospital pharmacy convenience the same amount of income), which in 1-6 months before the higher authorities of the survey,http://www.tokyotales.com/mt_admin/mt-search.cgi, the lowest in January was 34.4 million, the highest in June was 92.3 million, but after investigation, in July it dropped to 91,000 yuan, only one-tenth of the previous month.
According to the material shows that in 2007 on suspicion of taking Medicare funds 6.917 million yuan, 3.78 million yuan in 2008, 4.833 million yuan in 2009, with 2010 of 4.218 million yuan from January to October, totaled 19.748 million yuan in four years. (Note: The above amounts are hospital inpatient pharmacy revenue convenience.)
The Secret
Medicare taking five steps
So, how exactly Xi'an Railway Hospital taking it national health insurance? The insider details about the specific means taking the hospital and taking the form of health insurance funds. Means taking Medicare hospital is not clever, this hedging instruments before the media have reported. The main hospital is handled using false hospitalization to defraud Medicare, before handling the primary first contact to have a Medicare card and is willing to exchange money on the card into cash "fake patients."
Taking concrete steps are divided into five steps: first, to find Medicare card holders railway workers or social insurance system staff. Asked whether the other party is willing to exchange money on the Medicare card into cash, if the other party agrees to make specific redemption amount, will be closed to the card, related to the specific operation by the staff.
The second step is generally divided into two possibilities, one may,woolrich felpe, hospital staff contact the exchange if it is clinical departments, the general will choose to build indoor undergraduate medical record,moncler outlet online, writing records, fill the bed, such as licensing, so this does not need to be hospitalized The "patient" will have a set of real admission procedures. Another possibility for the hospital staff to contact honor belongs to the non-clinical departments,http://forum.zyxel.com/index.php?item/create_form/1, these people will find a better relationship between the clinical departments to implement cash process.
The third step is for End after hospital admission, clinical departments, doctors would "patient" under long-term prescription orders, on the surface, the patient will have a doctor treat a single day, which reflects the patient daily medication,tiffany bologna, treatment, examination,hogan torino, and produce every day charges. Then the patient to the hospital costs are included in the daily fee system.
The fourth step,http://web.nua.edu.cn/forum.php?mod=viewthread&tid=321671, discharge formalities, all the formalities to be completed, the hospital will take the normal Medicare reimbursement procedures, part of Medicare reimbursement.
After the fifth step, the medical center will hit the Medicare hospital cost accounts, hospitals put some cash back to the cardholder deserve him. Then the remaining part of the hospital in accordance with the provisions of an internal pro rata allocation, are all related to the department according to the proportion of money.
The Secret
Take account set up virtual departments
In the whole process of taking health insurance,dove comprare woolrich online, hospital revenue in order to be able to distinguish between normal and taking Medicare funds income, in particular the establishment of the "hospital pharmacy 2" and "medical examination" of these two virtual sections.
Insiders told reporters during a hospital's billing system, the patient will have a computer accounting interface, perform all sections marked "medical examination" and "hospital pharmacy two" false cases are in the interface, which occurs In fact, all costs included in the convenience of all pharmacies. This interface disappeared after the patient is discharged, you can not bring up the original cross-checks. However, according to the clinical staff to reflect, hospital billing summary and detail, Finance and Information Branch bottomed account exists,http://www.fgzx.org/?action-viewcomment-itemid-146937, you can verify the same project and data.
Reporters saw the material insider provided a false patient named Valley × Na computer accounting interface, hospital number is 38986, the implementation of the department for "medical examination" and "hospital pharmacy 2" and outside the three families, totaling three sections. In the computer accounting interface, doctor name column displays the patient had been in the hospital ultrasound treatment, pressure treatment, extracorporeal shock wave lithotripsy,http://jfy4ghtuertfy.bloguez.com/jfy4ghtuertfy/4856010/apeboard.cgi, B-routine examination and other projects, the implementation of these projects symmetrical sections are " physical examination. " Reporters in the other two hospitalized No. 38990 × Joe Ma Bin and hospital number 38991 × Xia computer accounting interface also saw the same situation.
This three computer accounting interface exactly what is wrong with it? Insiders said that from the computer screen to see the accounting, according to conventional speaking, an all expenses occurred during hospitalization patients can not just enter "outside the three subjects," "hospital pharmacy 2" and "medical examination" This three departments . For ultrasonic treatment, pressure treatment, extracorporeal shock wave lithotripsy, B-routine examination and other projects, the surface is credited to "medical examination" Branch, in fact included a convenient pharmacy. This approach does not meet the hospital routine processes, because the patient examination test different functions corresponding hospital departments, such as electrocardiogram, radiology, CT, physiotherapy, etc. These sections are independent accounting department.
Insiders said the hospital did not actually "medical examination" and "hospital pharmacy 2" these two departments. According to insiders and related accounting Finance staff said the hospital is approved by the virtual established a few years ago,http://dandylion.info/epad/epad.cgi, there were written approval.
November 30, reporters Login Xi'an Railway Hospital site, on the site of a hospital department setting, the reporter saw the hospital clinical departments and 13 medical departments in seven no "physical examination" and "hospital pharmacy 2 "The two departments.
Questioning
Why is difficult to be discovered?
Medicare taking four years of nearly 20 million yuan of funds,nike tn, which is not a hospital for a small number, but why such a long time it has not been found? Insiders say, first of all because the railway hospital inpatient medical center submitted Medicare accounts do not show such a computer accounting interface, so Medicare inspection, verification staff were also unable to contact. Medicare is the inspection, verification and inspection staff, the hospital provides only general accounts, only inpatient classification project cost,woolrich outlet italy, which does not show these costs flow into the department.
Secondly, computer accounting interface is password protected, must know the password to enter the job, but the password only department director and the department of clinical involvement nurse know, very few people will be exposed to critical computer accounting interface . Moreover, the patient after discharge, computer accounting interface will be converted into another format, even if it was exposed to, and can not find them strange.
Third,hogan outlet milano, because of the large number of people suspected of involvement, involving multiple hospital departments of Finance, assessment office, pharmacy and other convenience, although the participants do not know the details of the case, but as early as accustomed, surprising. This form of taking Medicare because of an organized, large scale, long duration,hogan spaccio, but also reap "benefits", naturally, no one will "self-report."
Xi'an Railway Hospital on suspicion of taking a huge issue of truth in the end how Medicare? We look forward to the relevant departments to uncover the mystery.
Part of false patient information provided by insiders
(Outside the three subjects)
August 18 Information:
Patient: Lee × Health, 7, August 13 hospitalized;
Wang × sea, 8, August 13 hospitalized. August 27 Information:
Patient: Lee × Health, 7, and discharged;
Song × law, 9;
Added Lu × 4 degrees, 10 × Zhao Tao;
......
October 9 Information:
Patient: 1 × Zhao Rong, Liu × 7 Juan, 17 × Wu Bin, 18 × Hin October 25 Information:
Patient: 14 Lee ×, 18 ×  Xu Yuan Wen / Chart reporter Qin new