I. First of all, confirm whether it is a provincial medical treatment or a cross-provincial medical treatment, and if it is the former, you don't need to file a record.
Second, if it is a cross-provincial medical treatment, the insured person has the following two ways of filing:
(1) Offline
First, go through the referral procedures, and then choose the off-site referral medical institutions, and then go through the filing of direct settlement for off-site medical treatment with the Referral and Transfer Determination Form and social security card in the medical insurance office in the place where the insured person is insured.
1. Patients with valid documents (valid residence certificate issued by the resident public security organ, social security card and its copy, referral and transfer determination form, and information on the condition of the patient issued by the admitting hospital) go to the local agricultural cooperative management department to apply for the record of medical treatment in a different place.
2. The local Farmers' Cooperative Management Department will review the patient's application for medical treatment, prepare the relevant documents, and submit the application form for medical treatment and attachments to the provincial Farmers' Cooperative Management Department for review.
3. After the provincial agricultural cooperative management department has completed the examination, the application form and attachments will be submitted to the provincial agricultural cooperative management department for examination.
4. After the provincial Farmers' Cooperative Management Department has completed the examination, the application form and attachments will be submitted to the provincial Farmers' Cooperative Management Department of the province of origin for examination.
5. After the provincial Farmers' Cooperative Management Department of the province of origin has completed the examination and approval, the application form and attachments will be submitted to the local Farmers' Cooperative Management Department of the place of origin for examination and approval.
6. After the examination and approval of the local agricultural cooperative management department of the place of origin, the application form and attachments for medical record will be submitted to the local agricultural cooperative management department for examination and approval.
7. After the local Farmers' Cooperative Management Department has completed its review, the application form and attachments will be submitted to the Farmers' Cooperative Management Department of the place of origin for review.
8. After the examination and approval by the local Farmers' Cooperative Management Department, the application form and attachments will be submitted to the Farmers' Cooperative Management Department of the patient's place of residence for examination and approval.
9. After the patient's local agricultural cooperative management department has completed the audit, the application form and attachments for medical record will be submitted to the original agricultural cooperative management department for review and approval, the patient can be reimbursed for medical treatment in foreign countries
The second online for the record
Dialing the 12333 hotline to apply for the record on line, along with technological development, with the conditions of Internet access to the insured person, but also can be Choose through the national health insurance service platform "APP or WeChat small program" state medical record "and Alipay APP for the record of foreign treatment, each region in order to more convenient for the record of the insured person for the record, in the province's WeChat public number also has the corresponding foreign medical insurance reimbursement record, after the record of the insured person can be direct The first thing that you need to do is to get a good deal on a new product, and then you'll be able to get a good deal on a new product.
Taking Alipay as an example:
1First, open the Alipay APP and click on the national government service platform.
2Then, click on the inter-provincial medical record
3Finally, click on the interface to start the record can be
Note
1. The relocation of people need to be hospitalized, should be by telephone and other ways in the medical insurance agency for the record, and then hold my social security card (card) and ID card for medical hospitalization procedures, other medical The other procedures are the same as those for referrals.
2. In accordance with the relevant policies, the integrated fund is currently directly settled by the municipal agencies and designated hospitals. Starting from 2012, in principle, the settlement will be made once a month, and the settlement will be completed by the 15th of the following month. If the number of hospitalizations is small, it can be settled quarterly.
3. In general, only inpatient and emergency charges can be reimbursed for medical treatment in other places, and only a few cities can reimburse and settle outpatient charges;
4. Reimbursement scope and reimbursement ratio of medical treatment in other places: the medical insurance catalog of the place of medical treatment shall prevail, such as medicines, medical equipments, diagnostic and therapeutic items, and services, etc, which need to be included in the medical insurance catalog of the place of medical treatment to be reimbursed. The reimbursement rate is based on the policy of the place of participation, including the starting line, reimbursement rate, reimbursement limit and so on.
5. If the hospital supports direct settlement in other places, the settlement can be completed directly at the settlement window when you go through the discharge procedures. If there are special circumstances, such as system failure, then you still need to bring your medical information and return to your place of insurance to complete the reimbursement.
Legal basis
Article 4 of the Social Insurance Law of the People's Republic of China Article 4 of the Social Insurance Law of the People's Republic of China Employers and individuals within the territory of the People's Republic of China shall, in accordance with the law, pay social insurance premiums and have the right to inquire into the records of payment of premiums, records of the rights and interests of individuals, and to request that the social insurance administration agencies provide social insurance counseling and other related services.
Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise the payment of contributions for them by their own units.
Article 2 of the Social Insurance Law of the People's Republic of China The State establishes a system of social insurance covering basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance and other social insurance, and guarantees the right of citizens to receive material assistance from the State and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment or maternity.
Article 26 of the Social Insurance Law of the People's Republic of China: The basic medical insurance for employees, the new type of rural cooperative medical insurance and the basic medical insurance for urban residents shall be carried out in accordance with the provisions of the State.
Article 28 of the Social Insurance Law of the People's Republic of China shall be paid from the basic medical insurance fund in accordance with the state regulations for medical expenses that conform to the basic medical insurance drug catalog, diagnostic and treatment items, and standards for medical service facilities, as well as for emergency treatment and rescue.
Article 24 of the Social Insurance Law of the People's Republic of China stipulates that the State shall establish and improve the new rural cooperative medical care system. The management of the new rural cooperative medical care shall be regulated by the State Council.
Article 45 of the Constitution of the Chinese People's Republic of China Article 45 of the Constitution of the Chinese People's Republic of China Citizens of the Chinese People's Republic of China have the right to material assistance from the State and society in old age, sickness or loss of the ability to work. The State develops the social insurance, social relief and medical and health services necessary for citizens to enjoy these rights. The State and society protect the livelihood of disabled soldiers, provide compassionate care for the families of martyrs, and give preferential treatment to the families of soldiers. The State and society help to organize the work, life and education of blind, deaf, dumb and other citizens with disabilities.
Article 46 of the Constitution of the People's Republic of China Article 46 of the Constitution of the People's Republic of China Citizens of the People's Republic of China have the right and duty to receive education. The State fosters the all-round development of young people, adolescents and children in terms of morality, intelligence and physical fitness.