NCMS looks at the outpatient reimbursement process and how to reimburse NCMS outpatient clinics

1.Outpatient reimbursement: Be sure to visit a designated hospital. However, the insurance ratio of hospitals at all levels is different, and there is an upper limit for reimbursement every year, and the reimbursement ratio will be different due to the slight differences in medical insurance policies in various places;

2.Hospitalization reimbursement: According to the level of the hospital, the reimbursement ratio varies greatly.

Generally, the reimbursement ratio of township-level hospitals is 80%-90%; 70%-80% in county and municipal hospitals; The proportion of provincial or inter-provincial reimbursement will be lower. Similarly, the deductible will increase with the level of the hospital, from the township, county, city, and provincial level, the deductible will vary in different regions;

3.Reimbursement for serious illnesses: Reimbursement for critical illnesses generally has a deductible, and the deductible is also different according to the local standard of living, and the reimbursement ratio will also be adjusted according to the grade of the first expense.

The reimbursement process for NCMS outpatient clinics is as follows:

1. Insured patients should go to designated hospitals for medical treatment with cooperative medical certificates;

2. Charge at the outpatient billing office with examination and prescription;

3. Pay for outpatient medical expenses first;

4. Conduct inspections in relevant departments. Pick up medication at an outpatient pharmacy;

5. Hold the cooperative medical certificate, ID card, household registration booklet, invoice, etc. to the NCMS window to wait for review, and reimburse and receive reimbursement after review.

Social Insurance Law of the People's Republic of China

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 national regulations. Article 28.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations. Article 74.

Social insurance handling bodies shall obtain data needed for social insurance work through business handling, statistics, and investigations, and the relevant units and individuals shall provide them in a timely and truthful manner.

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.

NCMS outpatient reimbursement process: 1. Insured patients go to designated hospitals for medical treatment with cooperative medical certificates 2. 3. Pay the outpatient medical expenses by yourself; 4. Conduct inspections in relevant departments. Pick up medication at an outpatient pharmacy; 5. Hold the cooperative medical certificate, ID card, household registration book, invoice, etc. to the NCMS window for review, reimbursement and receive the reimbursement.

Social Insurance Law of the People's Republic of China

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

Article 27 Individuals who participate in the basic medical insurance for workers and workers who have paid contributions for the number of years specified by the state when they reach the statutory retirement age shall no longer pay the basic medical insurance premiums after retirement, and those who enjoy the basic medical insurance benefits in accordance with the provisions of the state for the number of years specified by the state may pay the premiums for the number of years specified by the state.

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

NCMS Outpatient Reimbursement Process:

1. Insured patients should go to designated hospitals for medical treatment with cooperative medical certificates;

2. Charge at the outpatient billing office with examination and prescription;

3. Pay the outpatient medical expenses by yourself;

4. Conduct inspections in relevant departments. Pick up medication at an outpatient pharmacy;

5) Hold a cooperative medical certificate, ID card, household registration book, and invoice on the first floor of the outpatient clinic;

6) Finally, go to the NCMS window for review, reimbursement and receive the reimbursement.

Hospitalization Reimbursement Process:

1. Insured patients should go to designated hospitals for medical treatment with cooperative medical certificates;

2) The doctor shall issue a hospitalization certificate, and the attending doctor shall check the patient's cooperative medical certificate, ID card, original and photocopy of household registration book and sign it;

3) Go to the NCMS window for hospitalization registration;

4) Pay for inpatient medical expenses by yourself;

5) Bring the discharge certificate, hospitalization invoice, cooperative medical certificate, patient ID card, household registration book, and recipient's ID card to the first floor of the hospital;

6) Go to the NCMS window for review, reimbursement and receive reimbursement.

The new type of rural cooperative medical care (hereinafter referred to as "NCMS") refers to the system of mutual medical assistance and mutual aid for farmers that is organized, guided and supported, voluntarily participated by farmers, raised by individuals, collectives and multiple parties, and mainly based on the overall planning of serious diseases. It raises funds in the form of individual payment, collective support and funding.

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 emergency and rescue medical expenses, in accordance with the provisions of the state from the basic medical insurance ** payment.

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.

NCMS reimbursement process 1. Outpatient reimbursement process (1) Insured patients go to designated hospitals for medical treatment with cooperative medical certificates; (2) Charge at the outpatient fee office with the prescription of the examination and hunger; 3. Pay the outpatient medical expenses by yourself; 4. Conduct inspections in relevant departments. Pick up medication at an outpatient pharmacy; 5) Hold a cooperative medical certificate, ID card, household registration book, and invoice on the first floor of the outpatient clinic; 6) Finally, go to the NCMS window for review, reimbursement and receive the reimbursement. 2. Hospitalization reimbursement process (1) The insured patient shall go to the designated hospital for medical treatment with the cooperative medical certificate (2) The doctor shall issue the hospitalization certificate, and the attending doctor shall check the patient's cooperative medical certificate, ID card, original and photocopy of household registration book and sign; 3) Go to the NCMS window for hospitalization registration; 4) Pay for inpatient medical expenses by yourself; 5) Bring the discharge certificate, hospitalization invoice, cooperative medical certificate, patient ID card, household registration book, and recipient's ID card to the first floor of the hospital; 6) Go to the NCMS window for review, reimbursement and receive reimbursement.

Social Insurance Law of the People's Republic of China Article 23 Employees shall 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 flexibly employed persons can participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with national regulations.

NCMS outpatient clinic will be reimbursed according to the following process:

1. Insured patients should go to designated hospitals for medical treatment with cooperative medical certificates;

2. Charge at the outpatient billing office with examination and prescription;

3. Pay the outpatient medical expenses by yourself;

4. In the relevant departments, the people are inspected for the new year's hunger. Pick up medication at an outpatient pharmacy;

5. Hold the cooperative medical certificate, ID card, household registration book, invoice, etc. to the NCMS window for review, reimbursement and receive the reimbursement.

Social Insurance Act

Article 26.

The treatment standards of basic medical insurance for employees, rural cooperative medical care for new limbs and hunger, and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

Social Insurance Act

Article 28.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.