{"id":3513,"date":"2009-01-14T09:27:29","date_gmt":"2009-01-14T07:27:29","guid":{"rendered":"http:\/\/www.ced.org.tr\/?p=3513"},"modified":"2009-01-14T09:27:29","modified_gmt":"2009-01-14T07:27:29","slug":"muayene-katilim-paylarinin-tahsil-edilmesi-hakkinda","status":"publish","type":"post","link":"http:\/\/www.ced.org.tr\/?p=3513","title":{"rendered":"MUAYENE KATILIM PAYLARININ TAHS\u0130L ED\u0130LMES\u0130 HAKKINDA"},"content":{"rendered":"

31.12.2008 tarih 27097 Say\u0131l\u0131 7.M\u00fckerrer Say\u0131l\u0131 Resmi Gazetede yay\u0131mlanan \u201c2008 Y\u0131l\u0131 Sosyal G\u00fcvenlik Kurumu Sa\u011fl\u0131k Uygulama Tebli\u011finde De\u011fi\u015fiklik Yap\u0131lmas\u0131na Dair Tebli\u011f\u201d ile yap\u0131lan d\u00fczenlemeler sonras\u0131nda, 01.01.2009 tarihi itibariyle yurtd\u0131\u015f\u0131 sigortal\u0131lar\u0131 gibi baz\u0131 sigortal\u0131 gruplar\u0131 i\u00e7in, muayene kat\u0131l\u0131m pay\u0131n\u0131n tahsilat\u0131n\u0131n ne \u015fekilde yap\u0131laca\u011f\u0131 konusunda baz\u0131 teredd\u00fctler ya\u015fand\u0131\u011f\u0131 \u00fcyelerimiz taraf\u0131ndan bildirilmektedir. <\/font><\/p>\n

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Tebli\u011fin 3.3 Numaral\u0131 maddesinin ikinci f\u0131kras\u0131n\u0131n (a), (b) ve (c) bentlerinde belirtilen ki\u015filerden muayene kat\u0131l\u0131m pay\u0131 tahsil edilmesi gerekenler i\u00e7in, bu tahsilat MUAYENEN\u0130N YAPILDI\u011eI SA\u011eLIK KURUMLARINCA K\u0130\u015e\u0130LERDEN YAPILACAKTIR. <\/font><\/p>\n

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A\u00c7IKLAMA: <\/font><\/font><\/strong><\/p>\n

2008 Y\u0131l\u0131 Sa\u011fl\u0131k Uygulama Tebli\u011fi\u2019nin 6.6 Muayene Kat\u0131l\u0131m pay\u0131 tahsili ba\u015fl\u0131kl\u0131 b\u00f6l\u00fcm\u00fcn\u00fcn 6.6.1. Ayakta tedavide hekim ve di\u015f hekimi muayenesi kat\u0131l\u0131m pay\u0131 tahsili maddesine <\/font><\/p>\n

c) \u0130stisnai durumlar nedeniyle Kurum bilgi i\u015flem sisteminden hasta takip numaras\u0131\/provizyon al\u0131namamas\u0131na ra\u011fmen gerekli sa\u011fl\u0131k yard\u0131mlar\u0131 sa\u011flanan, (3.3) numaral\u0131 maddenin ikinci f\u0131kras\u0131n\u0131n (a), (b) ve (c) bentlerinde belirtilen ki\u015filerden muayene kat\u0131l\u0131m pay\u0131 tahsil edilmesi gerekenler i\u00e7in muayenenin yap\u0131ld\u0131\u011f\u0131 sa\u011fl\u0131k kurumlar\u0131nca ki\u015filerden\u201d bendi eklenmi\u015ftir.<\/font><\/p>\n

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3.3. Provizyon i\u015flemleri<\/font><\/font><\/strong> <\/p>\n

(1) Kurumla s\u00f6zle\u015fmesi bulunan sa\u011fl\u0131k hizmeti sunucular\u0131 taraf\u0131ndan m\u00fcracaat eden ki\u015finin sa\u011fl\u0131k yard\u0131mlar\u0131ndan yararlanma haklar\u0131n\u0131n olup olmad\u0131\u011f\u0131n\u0131n tespiti i\u00e7in Kurum bilgi i\u015flem sistemi (MEDULA, MEDULA-optik, eczane provizyon sistemi) \u00fczerinden, T.C. kimlik numaras\u0131 ile hasta takip numaras\u0131\/ provizyon al\u0131nmas\u0131 zorunludur.<\/font><\/p>\n

\u00a0<\/p>\n

(2) Ancak; Kurumla s\u00f6zle\u015fmeli sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131nca, a\u015fa\u011f\u0131da s\u0131ralanan istisnai durumlar nedeniyle Kurum bilgi i\u015flem sisteminden hasta takip numaras\u0131\/ provizyon al\u0131namamas\u0131na ra\u011fmen gerekli sa\u011fl\u0131k yard\u0131mlar\u0131 sa\u011flanacakt\u0131r.
\u00a0
a) Sa\u011fl\u0131k yard\u0131mlar\u0131 yeterli prim \u00f6deme g\u00fcn say\u0131s\u0131 olmaks\u0131z\u0131n ve\/veya prim borcu olup olmad\u0131\u011f\u0131na bak\u0131lmaks\u0131z\u0131n Kurumca kar\u015f\u0131lanacak olan;
1) \u0130\u015f kazas\u0131na u\u011frayan ki\u015filer (Hizmet akdiyle bir veya birden fazla i\u015fveren taraf\u0131ndan \u00e7al\u0131\u015ft\u0131r\u0131lanlar i\u00e7in i\u015f kazas\u0131 b\u00f6l\u00fcm\u00fc doldurulmu\u015f vizite k\u00e2\u011f\u0131d\u0131 faturaya eklenir. Sadece i\u015f kazas\u0131 nedeniyle sunulan sa\u011fl\u0131k hizmeti bedelleri \u00f6denir),<\/font><\/p>\n

2) Meslek hastal\u0131\u011f\u0131na u\u011frayan ki\u015filer (meslek hastal\u0131\u011f\u0131n\u0131n Kurumca tespiti \u015fart\u0131yla sadece meslek hastal\u0131\u011f\u0131 nedeniyle sunulan sa\u011fl\u0131k hizmetleri bedelleri \u00f6denir),<\/font><\/p>\n

3) T\u0131bben ba\u015fkas\u0131n\u0131n bak\u0131m\u0131na muhta\u00e7 ki\u015filer (\u00d6z\u00fcrl\u00fcl\u00fck \u00d6l\u00e7\u00fct\u00fc, S\u0131n\u0131fland\u0131r\u0131lmas\u0131 ve \u00d6z\u00fcrl\u00fclere Verilecek Sa\u011fl\u0131k Kurulu Raporlar\u0131 Hakk\u0131nda Y\u00f6netmelik kapsam\u0131nda, yetkilendirilmi\u015f \u00f6z\u00fcrl\u00fc sa\u011fl\u0131k kurulu raporu vermeye yetkili sa\u011fl\u0131k kurulu\u015flar\u0131nca a\u011f\u0131r \u00f6z\u00fcrl\u00fc oldu\u011funu g\u00f6sterir \u201c\u00d6z\u00fcrl\u00fc Sa\u011fl\u0131k Kurulu Raporu\u201d faturaya eklenir),<\/font><\/p>\n

4) Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca duyurulan \u201cBildirimi Zorunlu Bula\u015f\u0131c\u0131 Hastal\u0131klar Listesi\u201d nde yer alan hastal\u0131k tespit edilen ki\u015filer (sadece bu hastal\u0131\u011f\u0131 nedeniyle sunulan sa\u011fl\u0131k hizmeti bedelleri \u00f6denir),
5) Acil haller nedeniyle m\u00fcracaat eden ki\u015filer (sadece acil hal nedeniyle sunulan sa\u011fl\u0131k hizmeti bedelleri \u00f6denir),<\/font><\/p>\n

6) Koruyucu sa\u011fl\u0131k hizmetleri sunulacak ki\u015filer (sadece koruyucu sa\u011fl\u0131k hizmeti bedelleri \u00f6denir),
\u00a0
7) Gebeli\u011fin ba\u015flad\u0131\u011f\u0131 tarihten itibaren do\u011fumdan sonraki ilk sekiz haftal\u0131k, \u00e7o\u011ful gebelik halinde ise ilk on haftal\u0131k s\u00fcreye kadar olan gebelik ve anal\u0131k halini kapsayan anal\u0131k haliyle ilgili rahats\u0131zl\u0131k ve \u00f6z\u00fcrl\u00fcl\u00fck hallerinde sa\u011fl\u0131k hizmeti sa\u011flanan kad\u0131nlar (sadece anal\u0131k hali nedeni ile sunulan sa\u011fl\u0131k hizmeti bedelleri \u00f6denir),
\u00a0
8) 18 ya\u015f\u0131n\u0131 doldurmam\u0131\u015f ki\u015filer. (n\u00fcfus c\u00fczdan fotokopisi faturaya eklenir)
\u00a0
b) Yabanc\u0131 \u00fclkelerle yap\u0131lan sosyal g\u00fcvenlik s\u00f6zle\u015fmeleri kapsam\u0131nda Kurum sa\u011fl\u0131k yard\u0131mlar\u0131ndan yararland\u0131r\u0131lan ve Sosyal G\u00fcvenlik \u0130l M\u00fcd\u00fcrl\u00fcklerince d\u00fczenlenmi\u015f ve onaylanm\u0131\u015f \u201cSosyal G\u00fcvenlik S\u00f6zle\u015fmesine G\u00f6re Sa\u011fl\u0131k Yard\u0131m Belgesi\u201d\u00a0 ile m\u00fcracaat eden ki\u015filer (Kurum bilgi i\u015flem sisteminde m\u00fcstahakl\u0131k sorgulamas\u0131n\u0131n yap\u0131lmas\u0131 sa\u011flan\u0131ncaya kadar),
\u00a0<\/font><\/p>\n

c) SUT\u2019un (1.2.4) numaral\u0131 maddesinin (a) bendi hari\u00e7 olmak \u00fczere di\u011fer bentlerinde say\u0131lan ki\u015filer (say\u0131lan bentlerde belirtilen Kanunlara tabi olduklar\u0131n\u0131 g\u00f6sterir belge \u00f6rne\u011fi fatura ekinde g\u00f6nderilir)<\/font><\/p>\n","protected":false},"excerpt":{"rendered":"

31.12.2008 tarih 27097 Say\u0131l\u0131 7.M\u00fckerrer Say\u0131l\u0131 Resmi Gazetede yay\u0131mlanan \u201c2008 Y\u0131l\u0131 Sosyal G\u00fcvenlik Kurumu Sa\u011fl\u0131k Uygulama Tebli\u011finde De\u011fi\u015fiklik Yap\u0131lmas\u0131na Dair...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3513","post","type-post","status-publish","format-standard","hentry","category-ced"],"aioseo_notices":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3513","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3513"}],"version-history":[{"count":0,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3513\/revisions"}],"wp:attachment":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3513"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3513"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3513"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}