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Resident in Shenyang for medical insurance report, settled in Hefei on the spot. Retired employees of Shenyang enterprises who go to Hefei to live in Hefei shall directly go to the medical insurance bureau where the Shenyang medical insurance relationship is located for retirees to live in other places for medical treatment. After that, the cost of hospitalization in the designated institution of Hefei medical insurance shall be settled directly by the institution in the place of medical treatment in Hefei.
According to the Ministry of Human Resources and Social Security and the Ministry of Finance's Notice on Doing a Good Job in the Direct Settlement of Cross-provincial and Non-local Medical Expenses for Basic Medical Insurance, Ministry of Human Resources and Social Security issued No. 2016 No. 120.
1. Target tasksBy the end of 2016, the national network will be basically realized, and the direct settlement of hospitalization medical expenses for retirees will be launched across provinces and places; In 2017, it began to gradually solve the direct settlement of inpatient medical expenses for retirees resettled in other provinces, and expanded to direct settlement of inpatient medical expenses for those who meet the referral requirements at the end of the year. Combined with the reform of the local household registration and residence permit system, long-term residents and permanent staff in other places will be gradually included in the coverage of direct settlement of medical expenses for medical treatment and hospitalization in other places. 2. Basic principles (1) Standardization and convenience.
Insist on providing convenient and fast settlement services for the insured, and the insured only need to pay the inpatient medical expenses borne by the individual according to the regulations, and other expenses shall be paid by the institution and the designated medical institution according to the agreement after review. 3. Standardize the process of seeking medical treatment in other places (5) Standardize the process of transferring out. Before the insured person seeks medical treatment across provinces and places, he or she should register with the institution in the place of insurance.
The local economic institution shall establish a database of personnel for the filing of medical treatment in other places for the insured persons in accordance with local regulations, and realize dynamic management. The local economic institutions shall report the information of the medical personnel in other places to the social insurance economic institutions of the Ministry of Human Resources and Social Security (hereinafter referred to as the ministry-level economic institutions) to form a national database of personnel for the filing of medical treatment in other places, so that the local economic institutions and designated medical institutions can obtain the information of the insured persons who seek medical treatment in other places. (6) Standardize the settlement process.
When the insured person is discharged from the hospital for medical treatment in another place, the medical treatment institution shall transmit the information such as the hospitalization medical expenses of the remote medical treatment personnel to the insured local economic institution in real time through the national remote medical treatment settlement system according to the national unified list of major categories of expenses, and the insured local economic institution shall calculate the amount to be paid according to the local regulations according to the major types of expenses, distinguish the amount to be paid by the insured person and the medical insurance, and return the calculation results to the designated medical institution in the place of medical treatment through the national remote medical treatment settlement system. It is used for direct settlement between designated medical institutions and insured persons.
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Is it a maternity insurance record? It is possible to change the hospital, just go directly to the window of the Health Insurance Bureau.
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Legal analysis: medical treatment in other places requires the insured person to register with the local agency before seeking medical treatment in another place, and the agency in the insured place shall go through the filing procedures for the insured person in the other place in accordance with local regulations.
Legal basis: Notice of the Ministry of Human Resources and Social Security and the Ministry of Finance on Doing a Good Job in the Direct Settlement of Hospitalization Medical Expenses for Cross-provincial and Non-local Medical Treatment of Basic Medical Insurance 3. Standardize the process of medical treatment in other places.
5) Standardize the transfer-out process. Before seeking medical treatment across provinces and places, insured persons should register with the agency in the place where they are insured. The agency in the place of insurance shall handle the filing procedures for the insured persons in different places in accordance with local regulations, establish a database of personnel for the filing of medical treatment in other places and realize dynamic management.
The handling agency of the insured place shall report the information of the medical personnel in other places to the social insurance agency of the Ministry of Human Resources and Social Security (hereinafter referred to as the ministry-level handling agency) to form a national database of personnel for the filing of medical treatment in other places, so that the handling agencies and designated medical institutions in the place of medical treatment can obtain the information of the insured persons who seek medical treatment in other places.
(6) Standardize the settlement process. When the insured person is discharged from the hospital for medical treatment in another place, the handling agency in the place of medical treatment shall transmit the information of the inpatient medical expenses of the remote medical treatment personnel to the insured place in real time through the national remote medical treatment settlement system according to the national remote medical treatment settlement system, and the comma key agency in the insured place shall calculate the amount of the insured person and the medical insurance according to the local regulations, distinguish the amount that should be paid by the insured person and the medical insurance, and return the calculation results to the designated medical institution in the place of medical treatment through the national remote medical treatment settlement system. It is used for direct settlement between designated medical institutions and insured persons.
7) Strengthen cross-provincial comprehensive coordination. The ministerial-level agency is responsible for coordinating and supervising the timely allocation of funds in accordance with the regulations for the direct settlement of cross-provincial and non-local medical expenses for basic medical insurance (trial) (see annex, hereinafter referred to as the handling procedures). For provinces that unreasonably delay the disbursement of funds, the ministry-level agency may suspend the direct settlement service for inter-provincial and non-local medical treatment in the province.
The provincial-level agencies are responsible for coordinating and supervising the timely handing over of the prepaid and liquidation funds for cross-provincial and non-local medical treatment.
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Basically, everyone participates in medical insurance, and medical insurance can not only be used locally, but also can be reimbursed through medical insurance when accompanying people to see a doctor in other places. The reimbursement of medical insurance for the use of medical insurance in different places generally needs to be recorded, so how many days does it take for the medical insurance to be filed in other places? Let's find out.
Medicare reimbursement. Now it is very simple to apply for medical insurance in different places, and it can be handled within two working days. In order to facilitate groups such as grinders who work in different places all the year round and the elderly who have moved with them to seek medical treatment in other places, *** client applet.
Launched the National Health Insurance Administration.
Launched the "cross-provincial and remote medical treatment."
ICP Filing" service.
Click "Cross-provincial and non-local medical treatment filing" in the *** client applet, and submit personal information related to the filing, medical treatment location information, etc. After everyone submits the filing information, the Health Insurance Bureau will notify the applicant by SMS within two working days.
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Legal analysis: The effective time of the filing for cross-provincial and non-local medical treatment can be modified for the filing date for remote medical treatment. If the admission formalities are completed within the validity period of the record, regardless of whether the discharge date exceeds the validity period of the record, it is a valid record.
All localities are encouraged to actively explore the formulation of different filing validity periods for different groups of people. In principle, if the filing is filed at the provincial level or provincial capital, all designated medical institutions at the provincial level and the provincial capital city can support direct settlement. Materials Required:
Due to long-term residence, long-term work and other reasons, the insured persons in the city who are resettled in other places need to go through the registration procedures for remote medical treatment at the district social security sub-center of the insured person with the social security card or ID card of the insured person (in addition to the social security card or ID card of the insured person, the ID card of the principal is also required) before they need to be hospitalized directly in other places due to their illness. Specific process: The handling personnel handle the registration procedures for the insured through the remote medical registration system.
After the insured person selects and confirms the medical institution, submit the application for cross-provincial and remote medical treatment, fill in and generate a record form, and after saving, the registration information is immediately uploaded to the department's remote medical treatment settlement management platform. Print the form in duplicate and give one of the copies to the applicant after stamping.
Legal basis: "Qi Jianxi 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.
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Legal analysis: The name that has been registered in the household registration book can be changed, but if you want to change it, you still have to change it as soon as possible.
Legal basis: "Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers" Article 2 The following units and their employees in cities and towns in this province must participate in basic medical insurance in accordance with these Regulations: (A) enterprises and their employees; (2) State organs, public institutions, intermediary organizations, social organizations, private non-enterprise units and their employees; (3) Employers affiliated with the armed forces and their employees without military status.
These Regulations shall apply to the retirees of the above-mentioned units.
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.
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