In accordance with the provisions of the basic medical insurance does not pay for the cost of diagnostic and treatment programs **** five categories.
The first category is the class of service items: part of the medical service fee, out-of-hospital consultation fee, medical record cost, etc.; visit fee, examination and treatment of expedited fee, named surgery surcharge, named surgery surcharge, high quality and premium fee, self-invited special nurses and other special medical services.
The second category is the category of non-disease treatment programs: see the following analysis.
The third category is the category of diagnostic and therapeutic equipment and medically useful materials: the application of positron emission tomography device (PET), electron beam CT, ophthalmic excimer laser treatment instrument and other large-scale medical equipment for examination and treatment programs. Eyeglasses, denture, eye prosthesis, prosthetic limbs, hearing aids and other rehabilitative devices. All kinds of health care, examination and treatment equipment for personal use. Provincial price departments do not charge separately for disposable medical materials.
The fourth category is the category of therapeutic projects: all kinds of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation; myopic orthopedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other complementary therapeutic projects.
The fifth category is other categories: various scientific research, clinical verification of the diagnosis and treatment programs.
In addition, the basic medical insurance does not pay the cost of transportation, emergency vehicle fees; baby warming box fee, food warming box fee, nursing fee, cleaning fee, outpatient decoction fee; meal costs and other special living services. Patients are required to pay for all of the above items at their own expense.
What materials are needed for reimbursement of medical expenses? What are the formalities and procedures
(1) The required materials are:
1. Original hospitalization invoice;
2. Discharge record;
3. List of medical expenses or doctor's order (provided by the hospital);
4. Proof of one's identity card (copy of ID card or certificate of household registration);
5. Other (referral certificate, proof of part-time job, etc.).
(2) Formalities and Procedures
Patients in the city, directly in the fixed-point medical institutions to settle hospitalization expenses; transferred outside the city of hospitalization costs, within one month of the above materials to the township health center (co-management) for the settlement of procedures, after the first examination, the townships centralized to send to the municipal health insurance office to settle the bill.
Summary of the above is the editorial can be reimbursed for diagnostic items to make the relevant answer, I hope it can help you.
Legal basis
Article 29 of the Social Insurance Law of the People's Republic of China
The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance agency with the medical institutions and the drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.
Article 7
The social insurance administrative department of the State Council shall be responsible for the administration of social insurance throughout the country, and other relevant departments of the State Council shall be responsible for the relevant social insurance work within their respective areas of responsibility.
The social insurance administrative departments of the local people's governments at or above the county level are responsible for the administration of social insurance in their own administrative areas, and other relevant departments of the local people's governments at or above the county level are responsible for the relevant social insurance work within their respective areas of responsibility.