How to handle the process of reimbursement of medical insurance in other places?

In other places for reimbursement, the first step is to issue a discharge certificate, the amount of payment, laboratory test sheets, and medical history records, and a summary of the inpatient department, all of which are stamped and valid, and reimbursed at the location.

There are two situations: if your location is connected to the remote medical insurance network, the hospitalization and discharge will be directly reimbursed; If the medical insurance is not connected to the Internet, you will pay in advance when you are discharged, and then go back to the medical insurance bureau for reimbursement with all the information given at the time of discharge.

Out-of-town medical insurance reimbursement process.

Those who seek medical treatment in other places need to be approved by the relevant departments first. The place for approval of resettlement is: the district and county medical insurance center where the insured unit or street social security is located. After applying for the relevant approval form, fill in the relevant content.

Bring the relevant documents to the medical insurance department of the hospital in other places for stamping. Then return the relevant approval form to the handling agency at the place of application for approval.

The time limit for remote approval is usually one year, which is from the date of application to the day of the second year. It cannot be changed within one year. If the approval period has expired, the parties who are still in the other place need to go to the relevant department for re-approval.

It is indispensable for parties who are in other places to choose a hospital in another place, and the regulations on how many hospitals can be selected by medical patients are different in different regions. Generally, you can choose two to three.

For the medical expenses incurred by the parties in the designated hospitals in other places, the relevant reimbursement documents shall be mailed back to the original city for reimbursement, and family members may also be asked to help with reimbursement in the original city. Issues such as the standard of reimbursement will still be in accordance with the regulations of the city, and the relevant money can be collected by the family member on behalf of the family, or you can set up a relevant account to receive it.

Non-local medical insurance reimbursement ratio.

Medical expenses in the personal account of medical insurance can be regularly transferred to the Zigui Medical Insurance Bureau, and hospitals in other provinces should be designated hospitals for local medical insurance.

1. If hospitalization occurs, you need to report to the local medical insurance bureau for the record, and when you are discharged, you can go to the local medical insurance bureau to settle the inpatient medical expenses with the hospital's diagnosis certificate, discharge summary, medication schedule, medical expense receipt, and medical guarantee.

2. Hospitals in other provinces should be designated hospitals for local medical insurance.

3. The reimbursement ratio shall be handled according to the provisions of the document, and the general threshold fee shall be 88% for 3,000 yuan, 90% for 3,000-5,000 yuan, 92% for 5,000-10,000 yuan, and 95% for more than 10,000 yuan to the maximum payment limit, of which 80% for Class B drugs, 70% for valuable drugs, and 70% for special inspections and special **.

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Measures for handling medical treatment in other places.

Relatively speaking, it is relatively easy to apply for medical treatment in other places, which is simply as follows:

Filing first - select a hospital - seek medical treatment with a card.

1.Filing in the place of insurance.

Taking Hangzhou as an example, the applicant needs to bring the relevant documents to handle it in person, or you can entrust others to handle it on your behalf, and you must provide the ID card of the agent.

When applying for the record, it is necessary to choose a designated hospital in a different place.

2.Seek medical treatment at a designated hospital in another place.

After the filing procedures in the place of insurance are completed, you can go to the designated hospital with your medical insurance card to swipe your medical insurance card for medical treatment, and settle directly when you are discharged, saving the trouble of advance payment and subsequent reimbursement.

The medical insurance card is an important voucher for medical treatment in other places, so you must bring it well. Principles and Procedures for Claims Settlement by Insurance Companies

You can also use an electronic social security card to make it easier to pay bills.

According to the data of the National Health Insurance Administration, the number of designated medical institutions for cross-provincial and remote medical treatment in China continues to increase, and the number of filings and direct settlement continues to grow rapidly. As of the end of January 2019, there were 15,933 designated medical institutions for cross-provincial and non-local medical treatment, and 13,302 designated medical institutions at the second level and below. A total of 1.7 million cross-provincial and non-local medical treatment have been directly settled, and medical expenses have been 100 million yuan.

From this set of data, it can be seen how big the demand for medical treatment in other places is, and the measure of direct settlement of hospitalization has brought the most practical help to the floating population.

3.Forget about the impact of filing.

If I forget or don't have time to go to the local area for filing, can't I be reimbursed for medical expenses?

For example, you have to pay the medical expenses in advance first, and then take the materials back to the insurance place for reimbursement.

Therefore, filing in advance can help you save money and time, and don't spend a lot of unjust money.

4.What should I do if I go back to my hometown to see a doctor after applying for an off-site filing?

I believe this is also a question for many migrants.

In most areas, the medical insurance filing is valid for a long time, and you need to revoke the filing before you can continue to use it in your hometown.

There are also areas that can be used at the same time, such as Wuhan, where the filing in other places is valid for a long time, and it can be continued to be used when returning to your hometown to see a doctor.

Policies vary from place to place, and you can learn more about them at your local social security bureau.

Non-local medical insurance can be reimbursed, and emergency inpatient medical expenses incurred in other places due to special reasons such as business trips, family visits, vacations, etc., shall be reimbursed according to the regulations of the insured place. In the case of an emergency, it is allowed to be treated nearby. After that, return to the local medical insurance agency for reimbursement according to the regulations with the valid voucher issued by the hospital.

If you are away for a long time, you can apply for medical treatment in other places in advance.

The first step is to fill in the "Long-term Remote Medical Treatment Filing Form" through the national remote medical treatment filing applet or to the local medical insurance handling department for filing; The second step is to select a designated hospital, generally speaking, most of the tertiary hospitals can be settled in different places for social security; The third step is to take our medical insurance card to the designated hospital for direct medical treatment.

Keep the local medical records, diagnosis certificates, laboratory reports, discharge summaries, medical expense schedules, and medical expense reimbursement vouchers with financial and tax invoices, and go to the medical insurance center for review and reimbursement according to regulations.

How to get medical insurance reimbursement in different places? If you understand these, you can also be reimbursed for remote emergency treatment!

Legal analysis: The reimbursement process for medical insurance for medical treatment in other places is as follows: 1. The insured person shall bring the discharge summary, invoice, medication schedule, and certificate of medical treatment issued by the unit to the local social security agency for reimbursement; 2. For hospitalization fees, drug fees, etc., you can go directly to the medical insurance office of the hospital to go through the settlement procedures.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

The reimbursement process of medical insurance in different places is as follows: you must pay the medical expenses in advance, and ask for the original invoice, medication list, and medical record book at the medical treatment unit when you are discharged. Then, bring your ID card, medical insurance card, original list, medication list, medical record book and other materials to the local medical management center or the medical insurance settlement window of the designated medical institution for reimbursement.

According to the relevant laws and regulations, it is necessary to go to the city's medical insurance agency in advance to go through the procedures for confirming the dismantling of medical treatment in other places. The in-service insured persons who work and study in other places for a long time shall be uniformly applied for by the employer, and the other insured persons shall be handled by the unit or individual.

Social Insurance Law of the People's Republic of China

Article 29.

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit. The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits. Article 30.

The following medical expenses are not covered by basic medical insurance**:

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country. Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

The insured person shall fill in the "Registration Form for Medical Treatment in Other Places for Basic Medical Insurance" in accordance with the regulations of the place where the medical insurance is enrolled, and provide his ID card, social security card and proof of long-term residence in other places. For online filing, log in to the official website of social security to fill in the filing information, and go to the local social security bureau to fill in the filing registration form for offline filing. For reimbursement of medical treatment in a non-local hospital, the local hospital needs to issue a "referral and transfer certificate", and it is necessary to go through the filing procedures for medical treatment in other places.

It should be noted that it is more important to find a hospital to issue a "referral and transfer certificate", and the "referral and transfer" must also meet the three conditions of "step-by-step**, expert review, and two-way referral".

Article 23 of the Law of the People's Republic of China on Social Insurance with Remorse shall allow employees to participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other employees who are employed in the company may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

Hello dear and happy to serve you. The first step is to need a referral certificate from a county-level hospital or above. Take the medical insurance in a small town as an example, if you want to go to a different place for medical treatment, you must first go to a county-level hospital or above, and generally there will be a county-level hospital in the town, so that the doctor can issue a referral certificate.

The second step is to go to the hospital's social security window to get a stamp. The social security window of the hospital will generally be set up at the toll gate, take the referral certificate to the window, and the staff over there will naturally know how to sell this to help you get it! The third step is to go to the local social security bureau or social security office to register for going out**.

Generally, there are social security offices in cities and towns, and because they are a branch, they may be in inconspicuous places. Step 4: Get back to the county-level social security bureau for reimbursement after going out**. After completing the above three steps, you can go to the hospital in a big city**, and you can bring the invoice, medical book, social security card, and household registration book to your superior social security bureau for reimbursement!

Non-local medical insurance reimbursement process: 1. Non-local application - first apply for medical treatment in other places at the medical insurance center in the insured place, receive three approval forms in triplicate, and find the medical insurance offices of three (or two) designated hospitals at different levels in different places to stamp; 2. If you send it to the medical insurance center in the place where you are insured for the record, you can be hospitalized in another place, pay in cash, and send it back (or send it back) to the medical insurance center in the place of insurance with the settlement bill, discharge summary, and daily list for reimbursement. The following information needs to be prepared for the reimbursement of medical expenses of insured employees:

1. Personal medical insurance certificate; 2. Issuance of approval from a hospital above the second grade (referral and transfer form); 3. Hospitalization invoices, summary list of expenses and discharge summary stamped by the hospital where the patient is treated; 4. The original copy of the ID card of the person or the ** person and the valid bank card or passbook of the reimbursement personnel. Legal basis: "Regulations of the People's Republic of China on Basic Medical Insurance for Urban Employees" Article 6 The basic medical insurance premiums shall be levied and paid by the local taxation authorities of this province (hereinafter referred to as the collection authority).

Summary. Hello dear! The reimbursement process for medical insurance in other places is:

1. To apply, first apply for medical treatment in a different place at the medical insurance center in the place where you are insured, receive an approval form in triplicate, and stamp it at the medical insurance office of the designated hospital in the remote medical insurance; 2. Send it to the local medical insurance center for the record, and apply to the local medical insurance center for reimbursement with the settlement bills and daily lists. The specific management measures for medical services for emergency and rescue of insured persons shall be formulated by the overall planning area according to the actual local situation.

Hello dear! The reimbursement process for medical insurance for remote medical treatment is: 1. To apply, first apply for medical treatment in other places at the medical insurance center in the place where you are insured, receive the approval form in triplicate, and stamp it at the medical insurance office of the designated hospital for medical insurance in other places; 2. Send it to the local medical insurance center for the record, and apply to the local medical insurance center for reimbursement with the settlement bills and daily lists.

The specific management measures for the emergency and rescue services of the insured persons shall be formulated by the overall planning area according to the actual local situation.

The reimbursement process of medical insurance for medical treatment in other places is mainly that the medical expenses are paid by the individual in advance, and when the manuscript is completed, the person or his/her person will go to the medical insurance center for reimbursement. The following materials need to be prepared for the reimbursement of medical expenses of insured employees: personal medical insurance certificate; The city has the approval of the medical and filial piety hospital above the second grade (referral and transfer form); Hospitalization invoices, summary lists of expenses, and discharge summaries stamped by the hospital where they were treated; **The original and photocopy of the ID card of the person and the valid bank card or passbook of the reimbursement person.