Medical insurance reimbursement process:
1. Before each month 10, the designated medical institutions will report the expense list, hospitalization list and related materials of patients discharged from hospital last month to the medical insurance agency, which will be used as the basis for monthly pre-allocation and year-end final accounts after review.
2, medical insurance agencies monthly pre dial last month's hospitalization and special disease outpatient co-ordination fees.
3. Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly accounted for and settled immediately.
Emergency settlement procedure:
1. The medical expenses incurred by the insured for emergency rescue in non-designated medical institutions and medical institutions in different places in this Municipality shall be paid in advance by individuals or units.
2, after the emergency rescue, with emergency medical records, inspection, laboratory reports, invoices, medical expenses list until the medical insurance agencies in accordance with the provisions of the reimbursement procedures.
Legal basis: According to the scope of the national basic medical insurance, the details are as follows:
(1) service items.
(1) Registration fee, out-of-hospital consultation fee, medical record fee, etc.
(2) Special medical services, such as visiting fees, expedited fees for examination and treatment, additional fees for roll-call surgery, high-quality and low-price fees, and self-invited intensive care.
(2) Non-disease treatment projects.
(1) all kinds of beauty and bodybuilding, as well as non-functional plastic surgery and orthopedic surgery;
(2) various weight loss, weight gain and height increase projects;
(3) various health checks;
(4) all kinds of preventive health care and diagnosis projects;
(5) all kinds of medical consultation and medical appraisal.
(3) Diagnostic equipment and medical materials.
(1) Examination and treatment items of large medical equipment such as positron emission tomography (PET), electron beam cT and ophthalmic excimer laser therapeutic instrument;
(2) glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation devices;
(3) all kinds of self-use health care, massage, examination and treatment equipment;
(4) The provincial price department stipulates that one-time medical treatment cannot be charged separately.
(4) Treatment items.
(1) The organ source or tissue source of various organ or tissue transplants;
(2) Transplantation of organs or tissues other than kidneys, heart valves, corneal skin, blood vessels, bones and bone marrow;
(3) Orthopedic surgery for myopia;
(4) Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) others.
(1) various infertility (pregnancy) and sexual dysfunction diagnosis and treatment projects;
(2) all kinds of scientific research and clinical verification of diagnosis and treatment projects.
skill
The above answer is only for the current information combined with my understanding of the law, please refer carefully!
If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.