Guangzhou Medical Insurance Reimbursement Process

Legal analysis: firstly, when the medical expenses that meet the scope of reimbursement for sporadic medical expenses cannot be settled, the insured can advance the medical expenses in advance; Secondly, the insured person prepares relevant materials to report to the front desk of each medical insurance secondary agency; Then, the front desk of the agency examines the relevant materials and prints the relevant registration form to the insured; Finally, the handling agency will review the settlement expenses, and the Municipal Medical Insurance Bureau will transfer the medical expenses into the personal bank settlement account of the insured's social medical insurance card, and the reimbursement will be completed after confirmation by the insured.

Legal basis: Guangzhou Measures for Settlement of Medical Expenses of Social Medical Insurance.

Article 4 Medical insurance agencies shall sign contracts with designated medical institutions in the following ways within the total expenditure of the fund budget.

Calculate the medical expenses incurred by the insured in the designated medical institutions:

(a) the city designated single disease medical expenses by the "per capita cost limit" method of settlement.

(two) in the city's regional social medical insurance medical consortium (hereinafter referred to as the medical insurance medical consortium) signed an agreement on the integration of health and basic medical services, the medical expenses incurred in that year were settled in the form of "total payment".

(three) in addition to the designated single disease and medical insurance related hospitalization expenses, the use of "disease points payment" settlement, long-term hospitalization of designated diseases according to the bed day points payment.

(four) the basic medical expenses of outpatient specific diseases are settled by the way of "limiting the average cost of medical services and limiting the average daily bed cost".

(5) The expenses paid by the general outpatient service and emergency co-ordination fund shall be settled by means of "annual per capita medical service quota", and the prenatal examination and rabies vaccination of urban and rural residents' social medical insurance outpatient service shall be settled by means of "medical service project".

(six) the annual fee for signing the basic service package for family doctors shall be settled in the form of "the head limit of the number of people signing up for insurance".

(seven) medical expenses directly settled in different places shall be settled in the way stipulated by the state and the province.

(eight) other settlement methods as determined by the relevant provisions of this Municipality.

Sixth designated medical institutions in the last month of each year to declare the basic medical expenses paid after examination and approval, as the social medical insurance service quality guarantee, together with the annual liquidation expenses.