1. The insured who has gone through the registration formalities for medical treatment in different places will pay cash in advance for the medical expenses incurred in the designated medical institutions of medical insurance in different places.
2. The medical expenses incurred by the provincial-level insured who agree to go to designated medical institutions in Beijing and Shanghai for medical treatment after filing shall be paid in cash.
Second, the materials required for medical insurance reimbursement in different places
1, copy of application form for medical treatment in different places
2. The formal invoice of pharmacy (supervised by State Taxation Administration of The People's Republic of China Finance Department, with the details of purchased drugs listed on the invoice) or the outpatient receipt of designated hospital.
3. Patient ID card and agent ID card
4. My passbook bank card account number (except for rural credit cooperatives) (bank name is required in external account)
Remarks: Reimbursement shall be made once a year. Reimbursement expenses must be the expenses incurred in that year, and the time limit for reimbursement is mid-June 65438+before February of that year.
Third, the reimbursement process of medical insurance in different places
1. expense reporting units and individuals submit relevant reimbursement materials.
2. Acceptance personnel shall review the submitted materials.
3. Complete materials shall be reviewed, entered, settled and printed by the first-instance personnel. Inform incomplete materials in time.
4. The auditor reviews the expenses, prints the "settlement voucher for outpatient and emergency treatment of staff in provincial units" and then transfers it to financial payment.
Medical insurance settlement in different places
Medical insurance settlement in different places: The relevant person in charge of Chongqing Xuefu Hospital said that a settlement mechanism for medical treatment in different places should be established to explore the settlement methods for retirees' medical treatment in different places. Formulate measures for the transfer and connection of basic medical insurance relations, and solve the problem of cross-system and cross-regional transfer and connection of basic medical insurance relations between migrant workers and other migrant workers. Do a good job in connecting urban workers' medical insurance, urban residents' medical insurance, new rural cooperative medical system and urban and rural medical assistance.
Realizing medical insurance settlement in different places is a good policy and should be strongly supported. For a long time, domestic medical security has been managed in a territorial way. Medical institutions in different places are not subject to the policy constraints and specific management of their medical insurance co-ordination areas, and it is difficult for medical institutions in the first place to supervise and manage the medical behavior of medical institutions in the second place. Under this background, all localities have to implement the fixed-point management system of medical insurance, which brings various inconveniences to patients. At present, the population mobility between cities is very strong, and the floating population in many big cities has exceeded the local population, so the contradiction between medical insurance system and medical treatment in different places is increasingly prominent. Therefore, the flexibility and even reform of the fixed-point management of medical insurance has become the aspiration of the people and the general trend, which is very beneficial to building a harmonious society.
The first step to establish the settlement mechanism of medical treatment in different places is to explore the settlement method of local medical treatment for retired people in different places.
Improve the medical security service, promote the "one card" for the insured to seek medical treatment, and realize the direct settlement between the medical insurance agency and the designated medical institution. Farmers who participate in the new rural cooperative medical system are allowed to choose designated medical institutions for medical treatment in the overall planning area, simplifying the procedures for medical referral outside the county.
The person in charge of the 100 million-yuan married wife learned that the scope of reimbursement for basic medical insurance for urban and rural residents has expanded and the reimbursement ratio has increased, and it has been proposed to be 20 10. Through financial financing at all levels, the government has invested in the annual medical insurance account for each person 120 yuan; With the improvement of individual payment level, urban and rural residents can not only get the "top line" reimbursement with a per capita annual income of about 6 times higher after hospitalization due to serious illness, but also expect to get the reimbursement of outpatient medical expenses with lower threshold.
How to reimburse the medical expenses arising from medical treatment in different places?
(a) long-term residence in different places and medical treatment in the place of residence, should choose the local level 1, level 2, level 3 and specialized hospitals as hospitals, and go through the filing formalities in the social security sub-center of the insured place, and the medical expenses incurred shall be implemented according to the relevant provisions of this Municipality. If it is necessary to be transferred for treatment due to illness, relevant certificates shall be issued by the highest-level hospital that has been filed. Non-registered students and children attending kindergartens in this city, the hospitalization medical expenses incurred during the period of their origin (provincial scope) are paid according to the prescribed scope and standard of reimbursement (the emergency medical expenses incurred during the winter and summer vacations are implemented with reference to the Measures for the Administration of Resettlement Personnel), and their medical expenses are reported and reimbursed by the school and kindergarten within one month after returning to school (park).
(II) If the insured person needs to be transferred to a hospital outside this Municipality for treatment due to illness, the responsible hospital for referral and referral in this Municipality shall issue a certificate, which shall be approved by the human resources and social security department, and the medical insurance agency shall put it on record, and the medical expenses incurred shall be implemented according to the relevant provisions of this Municipality. If it is necessary to be referred to other hospitals due to illness, relevant certificates shall be issued by the transferred hospital. For the insured patients who go through the referral registration procedures and are referred to foreign medical institutions for treatment, the medical expenses within the "three items" of Chongqing's basic medical insurance will increase by 5%.
(three) during the insured's temporary trip, short-term business trip, study and training or vacation, medical expenses due to unexpected events in different places and the need for on-site hospitalization shall be implemented in accordance with the relevant provisions of this Municipality.