What materials are needed for reimbursement of NCMS for medical treatment in different places in the

Reimbursement process of NCMS for medical treatment in different places in the province:

1. Bring the patient's ID card, two one-inch color **, and NCMS medical certificate to the county joint management office for referral and filing procedures.

2. Bring the patient's ID card, NCMS medical certificate and referral filing procedures to the referral hospital for medical treatment and go through the NCMS hospitalization procedures.

3. After discharge, the patient should be reimbursed with the patient's ID card (or household registration book), NCMS medical certificate, copy of medical record, hospitalization settlement statement (some in the form of invoice), list of hospitalization expenses, and referral filing procedures.

Legal basis: Article 28 of the Social Insurance Law of the People's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses for emergency and rescue, and shall be paid from the basic medical insurance in accordance with national regulations.

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.

1. What materials are needed for reimbursement of NCMS for medical treatment in different places in the province?

1. The following materials are required for reimbursement of NCMS for medical treatment in different places in the province:

1) Inpatient medical records;

2) a list of expenses;

3) Hospitalization invoice;

4) Discharge summary;

5) Disease diagnosis;

6) ID card;

7) Hukou booklet;

8) Cooperative medical book.

2. Legal basis: Article 10 of the Insurance Law of the People's Republic of China.

An insurance contract is an agreement between the policyholder and the insurer to stipulate the relationship of insurance rights and obligations.

The policyholder refers to the person who has entered into an insurance contract with the insurer and has the obligation to pay the insurance premium in accordance with the contract.

An insurer refers to an insurance company that enters into an insurance contract with the policyholder and bears the responsibility of compensation or payment of insurance money in accordance with the contract.

Article 12. The policyholder of life insurance shall have an insurable interest in the insured at the time of the conclusion of the insurance contract.

The insured of property insurance shall have an insurable interest in the subject matter of insurance at the time of the occurrence of an insured event.

Life insurance is insurance that takes a person's life and body as the subject of insurance.

Property insurance is insurance that takes property and its related interests as the subject matter of insurance.

The insured refers to the person whose property or person is protected by the insurance contract and has the right to claim the insurance money. The policyholder can be the insured.

Insurance interest refers to the legally recognized interest of the policyholder or the insured in the subject matter of insurance.

2. What is the process of handling rural medical insurance in different places?

The filing process for NCMS remote medical treatment is as follows:

1. The insured shall go through the filing procedures for medical treatment in other places at the medical insurance agency in the insured city, and receive the record form for medical treatment in other places;

2. The insured person holds the record form and goes to the network hospital for medical treatment;

3. The insured person shall go through the hospitalization procedures at the window of the medical insurance office of the hospital with the record form for medical treatment in other places and the hospitalization notice, and pay the hospitalization deposit at 30%-40% of the total cost;

4. Discharge review and settlement. The individual bears the self-borne part, and the rest of the part that should be paid by the pooling fund shall be booked by the hospital;

5. After the discharge settlement procedures are completed, the insured person shall be discharged from the hospital with a detailed list of medical insurance expenses for medical treatment in other places, and the record form shall be kept in the hospital for filing.

Legal analysis: 1. The patient's family members can also call the participating agency to bring the patient's ID card (or household registration book), two one-inch color **, and the NCMS medical certificate to the local agency for referral and filing;

2. Bring the patient's ID card, NCMS medical certificate and referral filing procedures to the referral hospital for medical treatment, and go through the NCMS hospitalization procedures, only to find a cross-provincial designated medical institution for medical treatment;

3. Patient hospitalization**;

4. After discharge, the patient shall be reimbursed to the participating agency with his or her ID card (or household registration book), NCMS medical certificate, copy of medical record, hospitalization settlement statement (some in the form of invoice), list of hospitalization expenses, and referral filing procedures. Note: If the hospitalization reimbursement cannot be completed in real time due to special circumstances, the hospital needs to issue a copy of the "Instructions for Discharged Patients Transferred from Inter-provincial Medical Treatment and Fail to Enjoy the Immediate Settlement and Reimbursement Service", and return to the participating place for reimbursement.

Referrals play an important role in the off-site reimbursement process, and real-time reimbursement is not possible without referrals. The limitation period of the referral form is only 3 months, and no reimbursement will be made after the deadline, and an extension can be applied for if there are special circumstances.

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

Article 24: The State is to establish and improve a new type of rural cooperative medical system.

The management measures for the new type of rural cooperative medical care shall be stipulated by ***.

Article 25 The State shall establish and improve the basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy.

Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly over the age of 60 and minors from low-income families, etc., will be subsidized by **.

Legal analysis: reimbursement process for medical treatment in other places: 1) I or my family members apply for cross-provincial medical treatment filing at the place of insurance; 2) Choose to go to the designated hospital designated by the province for treatment, otherwise you will not be compensated. 3) The patient should bring the ID card, household registration booklet, cooperative medical certificate, admission certificate, referral form and referral SMS to go through the admission procedures; 4) When the patient is discharged, the settlement should be made at the NCMS window, and attention should be paid to bring complete information and pay personal expenses.

Legal basis: According to Article 24 of the Social Insurance Law of the People's Republic of China, the State shall establish and improve a new type of rural cooperative medical system. The management measures for the new type of rural cooperative medical care shall be stipulated by ***.

The following materials are required for reimbursement of NCMS medical treatment in other places:

1.The patient's original "Agricultural Cooperative Certificate", household registration booklet, and ID card;

2.The province's unified approval form for referral and transfer of new rural cooperative medical care; (For migrant workers or residents in other places, the approval form for referral and transfer of new rural cooperative medical treatment is not provided, and the certificate of the unit where the worker works or the department at or above the village level in the place of residence is required).

3.Proof of diagnosis;

4.Discharge certificate;

5.a summary list of inpatient medical expenses;

6.Invoices for hospitalization charges;

7.A copy of the inpatient medical record with the official seal.

The reimbursement process for NCMS remote medical treatment is as follows:

1.Filing for medical treatment in other places: Long-term people who work or live in other places can fill in the medical insurance declaration form for people working and living in other places, and go to the social security institution for review; If you need to seek medical treatment in a different place, you can also call to handle the referral filing procedures at the NCMS local agency with your identity information, social security card and relevant information.

2.After long-term remote work and residence personnel have passed the remote medical treatment, they can directly use their medical insurance cards to settle with their medical insurance cards in networked medical institutions and pharmacies; Patients who need to seek medical treatment in other places have gone through the referral procedures, and bring the materials to the referral hospital for medical treatment and hospitalization**.

3.If there is no direct settlement, the hospital will issue a "Description of Immediate Settlement and Reimbursement Service for Patients Referred for Inter-provincial Medical Treatment", and it is necessary to return to the participating place for reimbursement with the patient's ID card or household registration book, social security card, copy of medical record, hospitalization settlement statement, list of hospitalization expenses, referral filing procedures, etc.

The latest regulations on NCMS reimbursement in different places.

Coordinate the immediate settlement and referral process for regional emergency or migrant patients who participate in medical treatment in other places.

Emergency patients: Within 5 days, emergency patients should return to the Rural Cooperative Medical Center for re-referral with the emergency ** medical record, emergency receipt, and hospitalization deposit receipt issued by the provincial Qianyu medical institution.

Legal basis

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 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.

Article 24: The State is to establish and improve a new type of rural cooperative medical system.

The management measures for the new type of rural cooperative medical care shall be stipulated by ***.

The materials required for reimbursement of NCMS medical treatment in other places include the patient's "NCMS Certificate", household registration booklet, original ID card, diagnosis certificate, summary list of inpatient medical expenses and inpatient medical records. The reimbursement process of NCMS remote medical treatment is to first bring the materials to go through the referral filing procedures, and after being discharged from the hospital, you can go to the NCMS local agency for reimbursement. The materials required for reimbursement of NCMS medical treatment in other places include the patient's "NCMS Certificate", household registration booklet, original ID card, diagnosis certificate, summary list of inpatient medical expenses and inpatient medical records.

The reimbursement process of NCMS remote medical treatment is to first bring the materials to go through the referral filing procedures, and after being discharged from the hospital, you can go to the NCMS local agency for reimbursement.

1. What materials are required for NCMS reimbursement for medical treatment in other places?The following materials are required for reimbursement of NCMS medical treatment in other places:

1.The patient's original "Agricultural Cooperative Certificate", household registration booklet, and ID card;

Xun next to 2The province's unified approval form for referral and transfer of new rural cooperative medical care; (For migrant workers or residents in other places, the approval form for referral and transfer of new rural cooperative medical treatment is not provided, and the certificate of the unit where the worker works or the department at or above the village level in the place of residence is required).

3.Proof of diagnosis;

4.Discharge certificate;

5.a summary list of inpatient medical expenses;

6.Invoices for hospitalization charges;

7.A copy of the inpatient medical record with the official seal.

2. The reimbursement process for NCMS medical treatment in different placesThe reimbursement process for NCMS remote medical treatment is as follows:

1.Filing for medical treatment in other places: Long-term people who work or live in other places can fill in the medical insurance declaration form for people working and living in other places, and go to the social security institution for review; If you need to seek medical treatment in a different place, you can also call to handle the referral filing procedures at the NCMS local agency with your identity information, social security card and relevant information.

2.After long-term remote work and residence personnel have passed the remote medical treatment, they can directly use their medical insurance cards to settle with their medical insurance cards in networked medical institutions and pharmacies; Patients who need to go to another place for medical treatment have gone through the referral procedures and bring the information to the referral hospital for medical treatment and hospitalization**.

3.If there is no direct settlement, the hospital will issue a "Description of Instant Settlement and Reimbursement Service for Patients Referred for Inter-provincial Medical Treatment", and it is necessary to return to the participating place for reimbursement with the patient's ID card or household registration book, social security card, copy of medical record, hospitalization statement, list of hospitalization expenses, referral filing procedures, etc.

3. The latest regulations on reimbursement of NCMS in different placesCoordinate the immediate settlement and referral process for regional emergency or migrant patients who participate in medical treatment in other places.

Emergency patients: Emergency patients should return to the NCMS Center for re-referral within 5 days with the emergency ** medical record, emergency receipt, and hospitalization deposit receipt issued by the provincial medical institution.

Reminder: Migrant workers: Migrant workers and residents should return to the NCMS Center within 5 days with their work certificates and residence certificates to make up the referral form.

Coordinate the district agricultural cooperative office to send an electronic referral form - provincial designated medical institutions, if it is necessary to refer to a designated medical institution outside the province - send an electronic referral form - the national NCMS platform.