First go to the district and county health insurance agencies for manual reimbursement, and the relevant information will be submitted by the participating units.
1, need to provide reimbursement bills and materials:
(1) outpatient (emergency) clinics: receipts, drug prescriptions, checking and treatment fee details;
(2) hospitalization costs: receipts, cost lists, statements, medical diagnosis certificates;
(3) all kinds of checking and laboratory test reports must be accompanied by a detailed list.
2, reimbursement tips:
(1) health insurance has been real-time settlement of the cost of reimbursement need to fill out the "Application for Insurance Benefit", the amount of the claim according to the receipt of the individual out-of-pocket including (out-of-pocket one, out-of-pocket two) cumulative calculation. Medical expenses accumulated more than 10,000 yuan or more need to provide a copy of ID card;
(2) due to the end of the year reimbursement of more people, can be dispersed to the middle of the year at any time to reimbursement, be sure to be reimbursed within the year.
3. Regarding the payment of reimbursed medicines,
Beijing basic medical insurance reimbursement of medicines: the employees are paid by the medical insurance to the financial account of the unit, and the financial account of the unit is paid to me, and the retired persons are paid by the medical insurance to their own bank cards.
The industrial and commercial bank account for reimbursement of supplemental medical insurance drug costs should preferably be the same as the account of my payroll card, and the name of the account must be the same as the name of my ID card, and ensure that the account is effective in the long term.
Expanded Information
Recently, Beijing has formulated the "Notice on the Opinions on Reimbursement of Medical Expenses Related to Issues Prior to the Recognition of Work Injury", which optimizes the process of reimbursement of medical expenses incurred in treating the injured part or occupational disease prior to the recognition of work injury and facilitates the access to medical care for the workers who are injured at work.
According to the new regulations, if the medical expenses incurred by the injured worker for treatment of the injured part or occupational disease before the conclusion of the work injury determination are advanced by the medical insurance fund, the employer will hold the bottom sheet of the prescription, the receipt of the medical expenses, the detailed list of medical insurance expenses, and the voucher of the declaration and settlement and declare the settlement and audit to the district medical insurance agency.
The Workers' Compensation Insurance Fund shall pay the medical expenses in excess of the amount advanced by the Medical Insurance Fund, and shall refund to the Medical Insurance Fund the expenses advanced.
The new regulation eliminates the need for injured workers to go to the hospital for basic medical insurance refund, realizes the internal transfer between the Workmen's Compensation Insurance Fund and the Medical Insurance Fund, simplifies the reimbursement process, and allows "more information to run, fewer people to run," further facilitating injured workers' access to medical care.
People's Daily Online - 8 cases can apply for manual reimbursement of medical insurance
Beijing Municipal Bureau of Social Security - Simplified reimbursement process before the recognition of work-related injuries