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RPPMI01203_자보환자안내문(본원).rex

RPPMI01203_자보환자안내문(본원).rex 54 KB
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  1. <?xml version="1.0"?>
    2. 

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    3. 

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    6. 

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    8. 

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BDiagonalLineColor="0"/></CellStyles><Rows><Row Size="200"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="자동차보험 입원안내 및 진료비 본인부담 동의서" MultiLine="1" WordWrap="1" WordSpace="3" LineSpace="6" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="4" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="10" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="20" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="14"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="1" BaseCellRowIndex="0" BaseCellColIndex="0"/><Cell CellType="1" BaseCellRowIndex="0" BaseCellColIndex="0"/><Cell CellType="1" BaseCellRowIndex="0" BaseCellColIndex="0"/></Row><Row Size="1850"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" CanGrow="0" CanShrink="0" DataType="0" Text="   우리병원에 입원하신                            님의 쾌유를 기원드리며, 자동차사고 환자의 보험처리에 관한 사항을 다음과 같이 알려드리니 동 안내사항을 확인하시고 아래에 서명날인 하여 주시기 바랍니다.
    12. 

  12. 

  13. 1.                              에게 입원사실을 통보하셔야 하며, 이후 보험사로부터 진료비에 대한 지불보증서가 우리병원에 송부되어야만 자동차보험으로 처리가 가능합니다.
    14. 

  14. 

  15.                                            전화 053-420-5099
    16. 

  16.                                            전화 053-420-5058
    17. 

  17. 

  18. 2. 책임보험, 자손사고, 뺑소니사고 관련환자는 해당 진료과에서 진단서를 발급받아 보험회사로 제출하시면 진료비 지불보증 &lt;한도금액&gt;이 결정됩니다.
    19. 

  19. 

  20. 3. 입원은 기준병실(일반병실)을 사용하셔야 합니다.
    21. 

  21. (다만, 우리병원의 병실사정으로                                     하였을 경우에는 자동차보험 표준약관에서 인정하는                         에 한해 진료담당의사의 상급병실차액소견서(10,000원 본인부담)를 제출하면 그 차액을 자동차보험에서 부담하며, 그 외의 기간은                                하셔야 합니다.)
    22. 

  22. 

  23. 4. 진료비 본인부담 동의
    24. 

  24.  보험사에서 진료비 지불보증을 하더라도 다음 사항에 해당되는 경우 진료 등으로 인해 발생된 본인부담진료비는 환자가 전액 부담함에 동의합니다.
    25. 

  25.  가.                                                          에 대한 검사 및 진료비
    26. 

  26.  나. 진단서, 소견서 등 제증명서 발급비용
    27. 

  27.  다. 진료담당의사의 판단에 의하여                                                                                                            등 진료상 불가피한 진료비
    28. 

  28.  라. 보험사로부터 
    29. 

  29.  마. 보험사 및                                                                                                    그에 해당되는 검사 및 진료비 끝." 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VerticalAlignment="0" Text="가입된 보험회사담당자" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자2" Visible="0" X1="208" Y1="822" Width="800" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="자동차보험회사 지불보증서 FAX 요청" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자4" Visible="0" X1="212" Y1="882" Width="700" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text=" - 외   래 FAX : 053-426-9517," MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자5" Visible="0" X1="212" Y1="944" Width="700" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text=" - 응급실 FAX : 053-420-5098," MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자6" Visible="0" X1="892" Y1="1294" Width="600" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="부득이하게 상급병실에 입원" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자7" Visible="0" X1="902" Y1="1356" Width="448" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="일정기간(통상7일)" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자8" Visible="0" X1="704" Y1="1472" Width="600" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="환자 본인이 전액을 부담" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자9" Visible="0" X1="302" Y1="1766" Width="798" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="교통사고와 관련이 없는 기존질병 " MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자10" Visible="0" X1="982" Y1="1766" Width="318" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="(기왕증 등)" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자11" Visible="0" X1="950" Y1="1884" Width="950" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="자동차보험 진료기준 대상에서 제외되거나 인" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자12" Visible="0" X1="212" Y1="1946" Width="788" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="정되지 아니하는 특수시술, 비급여부분" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자13" Visible="0" X1="598" Y1="2002" Width="500" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="지불보증이 중지된 경우" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자14" Visible="0" X1="520" Y1="2062" Width="800" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="자동차보험진료수가 분쟁심의위원회가 " MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자16" Visible="0" X1="214" Y1="2120" Width="244" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="정 한 경우" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자15" Visible="0" X1="1314" Y1="2062" Width="582" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" Text="교통사고와 무관하다고 결" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="1" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Field" Name="필드2" Visible="0" X1="692" Y1="408" Width="434" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="0" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" CanGrow="0" CanShrink="0" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="0" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" Text="!환자정보" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" FieldID="3" FieldIndex="6"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control></ListControls><ConditionalStyles/><Script><![CDATA[]]></Script></Section><Section Type="2" Name="보고서바닥글" Height="35" Visible="3" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" CanGrow="0" CanShrink="0" ColumnWidth="0" ColumnDirection="0" ColumnSpacing="0" ColumnLayout="0" Repeat="0" UnderlayNext="0" DetailIteration="0" ForcedGH="0" KeepTogether="1" NewColumn="0" NewPage="0" PrintAtBottom="0" PageReset="0" SuppressBlankSection="0" SuppressRepeatedBlankSection="0" FillBlank="0" Exportable="1" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" GroupFieldID="-1" GroupFieldIndex="-1" GroupSortingFieldID="-1" GroupSortingFieldIndex="-1" GroupTOCFieldID="-1" GroupTOCFieldIndex="-1"><ListControls Type="0"/><ListControls Type="1"/><ConditionalStyles/><Script><![CDATA[]]></Script></Section><Section Type="8" Name="페이지바닥글" Height="30" Visible="3" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" CanGrow="0" CanShrink="0" ColumnWidth="0" ColumnDirection="0" ColumnSpacing="0" ColumnLayout="0" Repeat="0" UnderlayNext="0" DetailIteration="0" ForcedGH="0" KeepTogether="1" NewColumn="0" NewPage="0" PrintAtBottom="0" PageReset="0" SuppressBlankSection="0" SuppressRepeatedBlankSection="0" FillBlank="0" Exportable="1" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" GroupFieldID="-1" GroupFieldIndex="-1" GroupSortingFieldID="-1" GroupSortingFieldIndex="-1" GroupTOCFieldID="-1" GroupTOCFieldIndex="-1"><ListControls Type="0"/><ListControls Type="1"/><ConditionalStyles/><Script><![CDATA[]]></Script></Section></Page><Page Gutter="0" MirrorMargin="0" Orientation="1" PaperSize="2" PaperWidth="2100" PaperHeight="2970" ReportWidth="2100" TopMargin="50" LeftMargin="50" BottomMargin="50" RightMargin="50"/></Report>
    30.