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  "question": "医保基金监管中哪些行为属于重点风险？ 的适用条件和例外情况是什么？ 的适用条件和例外情况是什么？",
  "answer": "问题：医保基金监管中哪些行为属于重点风险？ 的适用条件和例外情况是什么？ 的适用条件和例外情况是什么？\n当前回答由检索依据直接组成，未生成无引用结论。\n规则依据：\n- …间：自然日、单日、自然月、单月、每季度、自然年、医保年度、其他 （5）医疗机构级别：三级、二级、一级及以下 （6）医疗机构类型：综合医院、中医医院、中西医结合医院、民族医医院、专科医院、康复医… [C3]\n风险案例依据：\n- …⼼电监护、⼼率变异性分析）。那么“遥测⼼电监护”属于重复收费，应当收“远程⼼电诊断”，别再 啦。 4-6 → “全器官⼤切⽚检查与诊断”的收费 ⼿术切除的胆囊、阑尾等病理检查应该收“⼿术标本检… [C1]\n- …药。” 也就是说：没有达到限制⽀付范围的条件时，医保基⾦不予⽀付⽽已，⽽不是不能⽤。 对医疗机构来说：如果临床医师认为患者确需使⽤有明确限制⽀付范围的药品，但未达到限制⽀付范围的条 违反药品说… [C2]",
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    "打开原文确认条款上下文。",
    "检查目录、规则、法规版本是否适用。",
    "确认是否还需 HIS 原始凭证补证。"
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