Town (township) new rural cooperative medical institutions should apply to the new rural cooperative medical management center for review and settlement within 1 to 20 days every month. For the medical expense documents that occurred in February of that year, an application for audit and settlement should be submitted to the new rural cooperative medical management center before October 20 of the following year at the latest.
Inter-annual hospitalization expenses, including those incurred before February 365438 (3 1) of that year and those incurred from next year, shall be settled separately. Compensation shall be made according to the actual amount paid each year. If the hospitalization expenses are settled across years, only one deductible line will be calculated.
(1) policy on reimbursement of medical expenses for ordinary participants. For those who have been hospitalized many times during the year, if the medical expenses for the first hospitalization exceed the deductible line, the expenses incurred for re-hospitalization shall be calculated cumulatively and compensated according to regulations. If the patient is hospitalized due to illness and is transferred to hospital for continuous hospitalization after approval, the hospitalization medical expenses shall be calculated cumulatively, reimbursed according to regulations and reported once a month.
Outpatient expenses for special diseases such as anti-rejection drugs, aplastic anemia in children and hemophilia after radiotherapy and chemotherapy for malignant tumors, renal dialysis and liver-kidney transplantation (or combined liver-kidney transplantation) are reported once a month. For many outpatient clinics during the year, if the accumulated medical expenses of outpatient clinics exceed the deductible line, they shall be reimbursed according to the regulations, and the specific time limit for reimbursement shall be formulated by each township.
(two) policies and procedures for the compensation of hospitalization medical expenses for two special groups:
(1) Participating farmers participate in other commercial medical insurance. If the payment is made by commercial medical insurance according to its standard, the participating patients will submit the reimbursement to the town (township) joint management office with a commercial insurance split sheet and a copy of all hospitalization bills. If it is reimbursed by the new rural cooperative medical system first, the new rural cooperative medical system will issue a cost division form, and then the commercial medical insurance company will reimburse it. The total compensation for the new rural cooperative medical system and commercial medical insurance shall not exceed the total hospitalization expenses incurred.
(2) The entitled groups participating in the new rural cooperative medical system shall be reimbursed by the Civil Affairs Bureau in accordance with relevant policies, and the participating patients shall provide a letter of introduction for reimbursement of entitled groups issued by the Civil Affairs Bureau to the town (township) joint management office, and the new rural cooperative medical system shall be reimbursed by the Civil Affairs Bureau according to the new rural cooperative medical system standards.
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