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장애판정 자료 공유되면, 보조기기 급여절차 간소화 가능할 것!

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작성자 한국장총 작성일2020-10-08 17:32:29 조회2,809회 댓글2건

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4c8c2332b399677fdfc1e4d87052e1f2_1602144979_275.jpg

 

국민건강보험공단에서는 1997년부터 장애인의 신체기능 개선 및 부상·질병의 위험 방지 등을 위해 88개 품목의 보조기기 보험급여를 실시하고 있습니다.

 

현재 급여절차는 장애인등록이 되면, 전문의의 처방이 이뤄지고, 공단에서 급여 승인 후 판매업소에서 보조기기를 구입하게 됩니다. 이후 의사의 검수확인까지 진행 완료되면, 공단에서 급여비를 지원받게 되는 시스템입니다. 이 외에도 통장사본 등 필요 서류만도 상당하고, 전산화까지 되어있지 않아 매번 수기작성·방문을 하여야 하는 상황입니다. 절차가 복잡하고 까다롭습니다.

 

4c8c2332b399677fdfc1e4d87052e1f2_1602148315_1825.PNG


국민건강보험공단에서는 이같은 절차를 간소화하기 위한 방안으로 장애판정 심사자료 연계를 통한 급여절차 개선회의를 요청해 왔습니다. 108일 진행된 회의에는 국민건강보험공단 급여사업실 조서현 팀장·박명진 과장, 한국시각장애인연합회 하성준 총장, 한국고용안정협회 조호근 센터장, 한국장애인단체총연합회 최용준 팀장, 한국장애인단체총연맹 권재현 국장·김은진 대리가 참석하였습니다.

 

아래는 현재 보조기기 품목별 급여절차 입니다.


4c8c2332b399677fdfc1e4d87052e1f2_1602146247_8018.PNG

 

연계 시스템을 통해 장애판정 심사자료를 국민건강보험공단측에서도 확인 가능하게된다면, 보조기기 지원 신청 장애인의 장애 관련 정보 확인이 가능하여 불필요한 절차를 간소화할 수 있을 것입니다.

 

이같은 전제 하에, 첫 째, 처방전·검수확인서가 불필요하다고 판단되는 지원 항목에 한하여 이같은 단계를 생략함으로 지원 절차를 간소화하자는 논의가 이뤄졌습니다.

 

의사 처방 및 검수확인 필요성이 낮은 품목은 처방전·검수확인 절차 생략

- ​체외용인공후두는 현재 처방전·검수확인 절차가 모두 필요한 항목이나 장애판정 자료에 체외용인공후두가 필요한 장애인이라 판단

   될 시, 굳이 처방전·검수확인 단계를 거치지 않도록 하고자 함

- 수동휠체어(일반형), 욕창예방매트리스·방석, ·후방 보행보조차, 돋보기, 망원경은 현재 검수확인은 하지 않고 있으나 처방전은

   제출하여야 하는 항목으로 처방전 제출 단계를 생략하고자 함

 

둘째, 현재 신청 절차가 전산화되어 있지 않아 불편이 잇따르는 바, 신청절차를 전산화하여 편의성을 도모하자는 논의가 이뤄졌습니다. 

 

○ 신청 방식을 전산화하여 편의성 도모

- 국민건강보험공단은 장애 인구 중 노인 비율이 높아 신청서를 수기로 작성하고 직접 방문하여 서류를 제출하는 방식으로 지원이 이

   뤄지고 있으나 시대 변화에 맞춰 전산화하는 방안에 대해 고민하고 있다며, 빠르면 내년 중 시행할 수 있을 것이라고 답변하였음

 

장애판정 심사자료 공유를 통해 절차를 간소화하고, 신청 방식을 전산화하여 보조기기 신청 장애인들이 편의가 증진되길 바랍니다.

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