1. Registration fee: the registration fee is the fee to be paid before seeing a doctor, which is used to register the patient's personal information and make an appointment with the doctor;
2. Examination fee: Examination fee is the fee to be paid for medical examination, including various imaging examinations (such as X-ray, CT scan, MRI, etc.). ) and laboratory tests (such as blood, urine, biochemistry, etc.). );
3. Laboratory expenses: laboratory expenses refer to the expenses that need to be paid when conducting various laboratory tests, which are used for the diagnosis and monitoring of diseases;
4. Surgery expenses: Surgery expenses are the expenses that need to be paid for surgical treatment, including surgery, anesthesia, surgical instruments, operating room use, etc.
5. Treatment fee: Treatment fee refers to the fees that need to be paid in the process of non-surgical treatment, including various treatment operations, physical therapy, rehabilitation treatment, etc.
6. Hospitalization expenses: Hospitalization expenses refer to expenses that need to be paid during hospitalization in the hospital, including ward expenses, nursing expenses, meals, etc.
7. Drug expenses: Drug expenses refer to the expenses that need to be paid when purchasing medical drugs, including prescription drugs and over-the-counter drugs.
Outpatient medical insurance reimbursement mainly includes:
1. Reimbursement scope: hospitalization expenses incurred by the insured in designated medical insurance hospitals or specialized hospitals, traditional Chinese medicine hospitals and tertiary hospitals selected by the individual;
2. Reimbursement ratio: the minimum payment for the first hospitalization in a natural year 1300 yuan, and every time in 650 yuan. The payment ratio is divided into three grades. Take a tertiary hospital as an example. The floating standards are: 30,000, 85 in service, 9 1 retired, 30,000-40,000 in service, 944,000 retired, 95 retired and 97 retired. 90 days of general hospitalization is a settlement cycle. Psychiatric hospitalization for 360 days is a settlement cycle, and the floating standard is halved. In a natural year, the overall fund will pay a maximum of 70,000 yuan;
3. Reimbursement process: At the time of discharge, the hospital and the individual settle the self-funded and self-funded amount, and the reimbursement amount of the overall fund is settled by the hospital and the district medical insurance center.
To sum up, the outpatient fee is the cost incurred when seeing a doctor in a hospital outpatient department. Including all kinds of inspection fees, laboratory fees, treatment fees, Chinese and western medicine fees, etc. The proportion and amount of outpatient expenses and hospitalization expenses are different. The deductible line and reimbursement ratio of outpatient and inpatient are different, and the maximum capping line is also different, which does not affect each other.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.