First, how to reimburse the hospital receipt for loss?
The process of reimbursement for the loss of hospitalization documents is to go to the hospital medical insurance office to apply for the loss of bills, fill in the reasons for the loss of invoices and sign them, and then the staff of the hospital medical insurance office will call up the electronic records of lost bills, print them out, sign the number and amount of reissued bills on the reissue form, and the agent will sign and seal them. Then take the certificate issued by the hospital and other details of the lost bill to the medical reimbursement office of the unit or street for reimbursement, and then the staff of the unit or street will hand over the lost materials to the medical insurance center in the area for settlement, and then make a second reimbursement according to the reimbursement list.
Second, how to calculate the proportion of medical expenses reimbursement?
Calculation standard of reimbursement ratio of medical expenses:
1. Employee reimbursement:1The medical expenses above 800 yuan can only be reimbursed after the on-the-job employees go to the hospital for emergency treatment. The reimbursement rate is 90% in community hospitals and 70% in other designated hospitals, with a maximum limit of 20,000 yuan. For retirees under the age of 70, the expenses above 1.300 yuan can be reimbursed, and the reimbursement ratio is 85% (non-community hospitals) and 90% (community hospitals).
2. Reimbursement in urban areas: students and children, the threshold of tertiary hospitals is 650 yuan, and the reimbursement ratio is 50%, with an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%. For the elderly aged 70 years and above, the threshold for tertiary hospitals is 650 yuan, and the reimbursement rate is 50%, with an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.
3. Where is the medical expense reimbursement going?
Go to the medical insurance business management center for reimbursement. After the insured is discharged from the hospital, the hospitalization invoice, discharge record, expense list, referral certificate, ID card or copy of household registration certificate signed or sealed by himself shall be handed over to the township joint management office, which shall be sent to the municipal medical insurance business management center in a centralized and unified way after examination. Unrecorded medical expenses and medical treatment items that are not reimbursed by urban workers' medical insurance are not included in the scope of reimbursement.
Legal basis:
Notice of the Ministry of Finance and the Ministry of Health on printing and distributing the Measures for the Administration of the Use of Medical Charge Bills.
Article 4 Medical bills are the original vouchers for accounting and the basis for supervision and inspection by departments of finance, health, social security, auditing and supervision.
Medical bills are valid vouchers for applying for reimbursement of medical expenses in accordance with relevant state regulations.
Article 9 The basic contents of outpatient bill include bill name, bill code, business serial number, hospital type, billing time, name, gender, medical insurance type, medical insurance payment method, social security number, item, amount, total, medical insurance overall payment, personal account payment, other medical insurance payment, self-expense, payee, payee, etc.
The basic contents of hospitalization bill include bill name, bill code, business serial number, hospital type, accounting time, name, gender, medical insurance type, medical insurance payment method, social security number, project, amount, total, prepaid amount, overdue amount, refund amount, medical insurance overall payment, personal account payment, other medical insurance payment, self-funded, payee, payee, etc.