How to be reimbursed by medical insurance for remote treatment, and how to be reimbursed by medical

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.

There is a very practical **, the country's 12333 official website, and then when you work and live in other cities, you can directly check which hospitals can directly do remote medical settlement, which will be particularly practical.

Reimbursement process for remote medical insurance. 1. The reimbursement ratio in other provinces is 30%, and the hospital invoice is taken to the local social security bureau for reimbursement.

2. Under special circumstances, due to business trips, family visits, vacations and other reasons, the expenses of emergency hospitalization in other places shall be reimbursed in accordance with the specific provisions of the medical insurance measures of the place of insurance. In general, in case of emergency, close diagnosis and ** are allowed. After the end of the day, the local medical insurance agency will be reimbursed according to the regulations with a valid certificate issued by the hospital.

3. In addition, if the retired children have settled in Beijing, they can apply for the placement of retirees at the medical insurance center of the insurance district. Once this is done, they can choose one or two designated hospitals to seek medical treatment. The cost is paid by the person and then reimbursed by the health insurance center in the area where the insurance is covered.

4. For long-term employees stationed abroad, they can also apply for medical insurance resettlement in other places, which can be applied for by the unit, and after they are done, they can choose one or two designated hospitals for medical treatment, and the expenses will be paid in advance by themselves, and then they will be reimbursed by the medical insurance center in the place where they are insured.

Legal analysis: 1. The insured persons shall bring the discharge summary, invoice, medication schedule, and remote medical treatment certificate issued by the noisy 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 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 **.

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 social insurance administrative department and the health administrative department should establish a settlement system for medical expenses for medical treatment in other places to facilitate the insured to enjoy basic medical insurance benefits.

1. Long-term residence in a different place for medical treatment.

1) Registration and filing.

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.

2) Select the point.

The filing needs to select a designated hospital, because patients can only be reimbursed by remote medical insurance if they seek medical treatment in the designated hospital where they are registered. If you don't know which hospitals can settle in other places, you can log on to the social insurance network to inquire.

3) Seek medical treatment with a card.

As long as the insured person does a good job of filing and registration, seeks medical treatment in the designated hospital, and then brings the social security card to handle the admission registration and discharge settlement, the medical expenses can be settled directly without paying in advance. Therefore, when you see a doctor, you must remember to bring your medical insurance card.

2. Refer to a hospital in another place for medical treatment.

For reimbursement of referral to a non-local hospital, a "referral and transfer certificate" issued by the local hospital is required, and the filing procedures for medical treatment in other places are also required.

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".

To put it simply: the local hospital is not capable** The tertiary hospital in the place cannot be identified** The referred hospital is ** of higher level.

3. Go out for temporary medical treatment.

If it is a temporary emergency department, hospitals in many cities now support "treatment first, reimbursement later", but the reimbursement ratio will be reduced.

If it is an ordinary outpatient clinic, the cost is relatively small, and you can keep the bill back to the insured place and submit the information for reimbursement.

If the cost is more, you can first register with the social security filing bureau of the place where you participate in the insurance (support the record), wait for the disease to be cured (pay the fee first), and then reimburse according to the standard of referral certificate.

When discharged, ask the medical unit for the original invoice, drug list, medical record book, get your ID card, medical insurance card, original list, drug list, medical record book and other materials, and go to the local medical management center or designated medical institution medical insurance settlement window for reimbursement.

The insured should register with the medical insurance agency where the insured is located in advance (if an emergency patient needs to be hospitalized in a timely manner when he or she is sick in a different place, he or she shall report to the medical insurance agency in the insured place within 3 days after hospitalization, and the medical expenses shall be paid in full by the individual in advance.)

The insured can go to a designated medical institution in another place for medical treatment only after completing the medical insurance confirmation procedures in another place. The amount of the personal medical account can be withdrawn from any business outlet of the medical insurance card, and is used for general illness expenses in the outpatient department of the branch and the cost of purchasing and dispensing medicines in pharmacies.

When discharged from the hospital, ask for the original invoice, medication list, medical record book at the medical treatment unit, bring your ID card, medical insurance card, original list, medication list, medical record book and other materials, and go to the local medical management center or the medical insurance settlement window of the designated medical institution for reimbursement.

The insured person must register with the medical insurance agency in the place of insurance in advance and file it for the record (if the emergency patient needs to be hospitalized in the hospital in time if he or she is sick in another place, he or she shall report to the medical insurance agency in the place of insurance for the record** within three days after hospitalization), and the medical expenses shall be paid in full by the individual first.

The insured person can seek medical treatment in a designated medical institution in another place only after completing the confirmation procedures for medical treatment in a different place. The amount of his personal medical account can be withdrawn from any of the business outlets of his medical insurance card and used for the expenses of general illness in the ward outpatient clinic and the cost of purchasing and dispensing drugs at pharmacies.

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. The reimbursement ratio is 88% for the threshold fee above 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 **.

How to be reimbursed for parents seeking medical treatment in a different place.

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.

At present, the social security card has been networked in 47 cities, and it can be directly reimbursed nearby.

For the application for resettlement of medical insurance for retired employees, most cities should first apply for medical treatment in other places at the medical insurance center in the place where they are insured, receive three copies of the approval form, and find the medical insurance office of three (or two) designated hospitals at different levels in different places (Chongqing) to seal it, and then send it to the medical insurance center in the place of insurance for the record, you can be hospitalized in another place, cash advance, and send it back (or send back) to the medical insurance center in the place of insurance with settlement bills, discharge summary, and daily list for reimbursement.

Only hospitalization can be reimbursed, but outpatient can not be reimbursed. The procedures for reimbursement need to go back to your hometown (insured place) for reimbursement are as follows:

1. Inpatient medical records.

2. List of expenses.

3. Hospitalization invoice.

4. Discharge summary.

4. Disease diagnosis.

5. ID card and household registration booklet.

6. Cooperative medical book (or card, card).

7. Transfer procedures or certificates (unit part-time work certificate or emergency certificate).

1. Generally, it cannot be used across regions; 2. Under special circumstances, emergency hospitalization medical expenses incurred in other places for business trips, family visits, vacations and other reasons shall be reimbursed in accordance with the specific provisions of the medical insurance measures of the place where the insurance is enrolled. In general, in the case of an emergency department, 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.

3. In addition, if you have retired and your children have settled in Beijing, you can apply for retirees to be resettled in other places by going back to the medical insurance center of the insured place, and you can choose one or two designated hospitals for medical treatment after doing so, and the expenses will be paid in advance first, and then you will go back to the medical insurance center of the insured place for reimbursement. 4. For long-term overseas employees, they can also apply for medical insurance for resettlement in other places, which can be applied for by the unit, and after doing so, they can choose one or two designated hospitals for medical treatment, and the expenses will be paid in advance first, and then reimbursed by the medical insurance center in the place where they are insured.

It depends on the insurance you buy in **, what is more important

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 medical treatment certificate 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.

Article 28 of the Law of the People's Republic of China on Social Limb Hunger Insurance stipulates that medical expenses that meet the requirements of the basic medical insurance drug list, diagnosis and treatment items, medical service facilities, and emergency and rescue shall be paid from the basic medical insurance in accordance with national regulations.

Reimbursement is possible. 1. Conditions for medical treatment in different places and provinces.

Resident staff: the company has been sending people to work in other places for a long time. However, such persons must be eligible for long-term residence in other places.

Retirees resettled in other places: Retirees whose children live in other places and whose household registration has moved to the local area. If the employee whose household registration has officially moved to the resettlement of the employee to participate in the medical insurance, the application for resettlement needs to be recorded.

Long-term residents in other places: long-term residents in other places and meet the requirements of the place of insurance, such people need to apply for a record of resettlement in the place of insurance, be hospitalized in a hospital included in the settlement system for medical treatment in other places, and directly settle medical expenses with their new social security card.

Eligible for referral from the insured place: patients who are hospitalized in other places, emergency and emergency hospitalizations, and transfer patients, and patients who have been referred by a local hospital if they need to seek medical treatment in other places because of illness.

2. The process of reimbursement of medical insurance in different places (filing first, selecting a point, and seeking medical treatment with a card.) ）

2. The "Declaration Form" filled in according to the regulations and stamped and recognized by the foreign social insurance (medical insurance) agency;

3. The completed "Declaration Form" will be returned to the social insurance agency responsible for the division of labor for review and confirmation. If you need to apply for a medical card in a different place in the province, you can register with the Audit Department of the Municipal Social Security Center with the "Declaration Form" after review and confirmation, and then go to the Social Security Card Management Department to go through the card production procedures for the remote network card in the province;

4. The personal social security card of the insured person cannot be used after the registration; If the insured person returns to the medical treatment, he or she should go to the municipal social security institution to cancel the medical report, and his personal social security card can be used in the designated medical institution from the next day;

5. The principle of reporting if there is a change in the medical report and not reporting if there is no change.

Hello. This problem about you is very easy to solve, if you need to reimburse the cost of hospitalization in another place, you only need to call ** to the medical insurance department of the household registration to clear Lu Meng, and now the whole country can be normal insurance medical insurance, agricultural cooperative or social security.

How to reimburse the medical insurance in a place should go to the local medical department to go through the transfer procedures.

Medical insurance is filed across provinces and places.

1) Discharge summary, invoice, and medication schedule issued by the hospital for medical treatment in other places.

2) My ID card, medical insurance card, and certificate of remote medical treatment issued by the unit (with the company's official seal), if not an enterprise is insured, the certificate of remote medical treatment issued by the unit is not required.

3) The transfer certificate issued by the local hospital must be issued by the attending physician, and then signed by the department director of the attending physician, and then the transfer certificate should be processed at the medical insurance office of the hospital.

4) The reimbursement for medical treatment in other places is 10% less than that for local medical treatment, and 20% less if there is no transfer certificate issued by a local hospital

The ** payment part of the inter-provincial medical treatment settlement can be prepaid before settlement between provinces, and the amount of prepaid funds is two months of payment. The prepayment and settlement funds for cross-provincial and non-local medical treatment shall be allocated by the provincial financial account of the participating place and the provincial financial account of the place of medical treatment. The provincial-level NCMS agency in the place of medical treatment shall collect and sort out the application materials for advance funds of the designated medical institutions in the jurisdiction, and submit them to the provincial-level NCMS agency in the participating place.

After examination and confirmation, the provincial-level NCMS agency in the participating area shall submit an application for fund allocation to the financial department at the same level. The provincial-level financial department of the participating place shall allocate the prepayment and liquidation funds to the provincial-level financial department of the place of medical treatment within 10 working days after confirming that all the funds for cross-provincial and non-local medical treatment have been paid into the provincial special financial account, and after reviewing the prepayment and settlement forms and the application plan submitted by the handling agency. After the provincial financial department of the place of medical treatment completes the collection of prepaid and liquidated funds, it shall feedback the collection information in writing to the provincial agency of the place of medical treatment within 5 working days, and the provincial agency of the place of medical treatment shall conduct accounting accordingly, and timely feedback the allocation and collection information to the provincial agency of the participating place.

Disputes and disputes arising from the examination of expenses shall be properly negotiated and handled by the provincial-level NCMS handling agencies in the place of medical treatment and the participating places in accordance with the agreement.

Legal basisSocial Insurance Law of the People's Republic of China

Article 4 Employers and individuals within the territory of the People's Republic of China who pay social insurance premiums in accordance with law have the right to inquire about payment records and records of individual rights and interests, and to request social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise their own units' contributions for them.

Article 74: Relevant units and individuals shall promptly and truthfully provide data required for social insurance work obtained by social insurance handling bodies through business handling, statistics, and investigations.

The social insurance agency shall establish archives for the employer in a timely manner, record the social insurance data such as the persons participating in the social insurance and the payment of premiums in a complete and accurate manner, and properly keep the original vouchers for registration and declaration and the accounting vouchers for payment and settlement.

The social insurance agency shall timely, completely, and accurately record the personal rights and interests records such as the contributions made by individuals participating in social insurance, the contributions made by employers, and the enjoyment of social insurance benefits, and periodically send the individual rights and interests records to the person free of charge.

Employers and individuals may, free of charge, inquire and check the records of their contributions and social insurance benefits from the social insurance agencies, and request the social insurance agencies to provide social insurance consultation and other related services.