I, the scope of application of the medical insurance code
Medicare code as the electronic credentials of medical insurance, the scope of application is wide. In the hospital settlement, patients can use the medical insurance code for identification and reimbursement. In addition, the medical insurance code can also be used in a variety of scenarios such as online purchase of medicines, medical insurance inquiries, and off-site medical treatment, providing patients with more convenient and efficient medical insurance services.
The process of using the medical insurance code for settlement and reimbursement
1. When the patient registers or consults in the hospital, he or she will show the medical insurance code to the hospital staff;
2. The hospital staff will scan the patient's medical insurance code through the code-scanning equipment to confirm the patient's identity and medical insurance information;
3. After the patient completes his or her consultation, the hospital will automatically calculate the amount to be reimbursed based on the type of medical insurance and reimbursement rate of the patient;
4. The hospital will automatically calculate the amount of reimbursement according to the patient's type of medical insurance and reimbursement ratio;
4. The patient will pay for the part of the expenses that the individual should bear through the medical insurance code, and the remaining part will be paid by the medical insurance fund;
5. The hospital will upload the relevant billing information to the medical insurance system, and complete the billing and reimbursement process.
3. Notes
1. When using the medical insurance code, patients should ensure the authenticity and validity of the medical insurance code and avoid using forged or invalid medical insurance code;
2. Patients should know the medical insurance policy and reimbursement ratio of their region before visiting the hospital in order to better enjoy the medical insurance treatment;
3. In case of any settlement problems or questions, patients can consult with the hospital staff or to the local health insurance department.
In summary:
Medicare code, as an electronic voucher of medical insurance, can be reimbursed at the hospital settlement. Patients only need to present the medical insurance code to the hospital to complete the identification and expense reimbursement process. When using the medical insurance code, patients should pay attention to ensure the authenticity and validity of the medical insurance code, and understand the medical insurance policy and reimbursement ratio in their region. The application of the medical insurance code provides patients with more convenient and efficient medical insurance services.
Legal basis:
The Social Insurance Law of the People's Republic of China
Article 28 stipulates that:
Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 19 of the Regulations on Supervision and Management of the Use of Medical Insurance Funds
Article 19 stipulates that:
Participants should hold their medical insurance vouchers to seek medical treatment and purchase medicines, and show them voluntarily for inspection. Participants shall keep their medical insurance vouchers in a safe place to prevent others from using them under false pretenses. If for special reasons it is necessary to entrust another person to purchase medicines on their behalf, they should provide proof of identity of the entrusted person and the trustee.
Opinions on Deepening the Reform of the Medical Security System
In terms of improving the payment mechanism of medical insurance, it is pointed out:
To comprehensively establish an efficient and convenient payment mechanism of medical insurance. Improve the total budget of the medical insurance fund, accelerate the formation of collective negotiation and consultation mechanism with designated medical institutions, scientifically and reasonably determine the total budget target of the medical insurance fund, and establish a dynamic adjustment mechanism compatible with the level of local economic and social development and the public's affordability. It has also promoted payment by disease type and by disease diagnosis-related grouping, and perfected the multi-dimensional and composite medical insurance payment methods such as per capita and per bed day. Actively exploring health insurance payment methods that are in line with the characteristics of traditional Chinese medicine, and encouraging the widespread application of appropriate technologies in traditional Chinese medicine. Vigorously promote the intelligent monitoring of health insurance to realize the transformation of health insurance expense settlement from partial audit to comprehensive audit, from post-correction to ex-ante prompting and supervision, and from pure control to the combination of supervision, management and service.