1, in accordance with the relevant provisions of the management of medical insurance referral and transfer, due to the limitations of medical technology and equipment, the need for further diagnosis; or due to the condition of the need to be transferred to other hospitals for further treatment of urban workers, urban and rural residents participating in the basic medical insurance, as well as relocation of people, are eligible for referral and transfer to hospital medical insurance treatment.
2. If an insured person needs to be transferred out of the city for treatment due to his condition, the chief of the third-level fixed-point medical institution shall propose and fill in the "Changzhou City Urban Residents' Basic Medical Insurance Out-of-City Referral and Consultation Approval Form," which shall be examined by the medical insurance office of the fixed-point medical institution and approved by the Municipal Medical Insurance Center for transferring to another hospital for medical consultation and diagnosis. The proportion of medical expenses incurred in accordance with the regulations paid by the medical insurance fund will be reduced by 10 percentage points on the basis of the prescribed payment standard for in-town medical treatment. For medical expenses incurred in transferring to a hospital outside of the city, the insured person shall go to the Municipal Medical Insurance Center for examination and confirmation of settlement of payment by presenting the "Changzhou Urban Residents' Basic Medical Insurance Card", medical records, discharge summary, detailed list of expenses, original invoices and other materials.
3, transfer procedures for the provisions:
(1) the transfer must be discussed by the section or the director of the section, the patient and his family can also be requested to the director of the section or the attending physician, approved by the medical department and the leadership of the hospital, in advance, contact with the hospital to be transferred to the consent of the other party before transferring to the hospital.
(2) When the patient needs to be transferred to a foreign hospital for hospitalization, the consent of the patient's unit must be obtained, and sometimes the approval of the Department of Health must be requested, and a certificate must be issued to complete the formalities. Acute infectious diseases, leprosy, mental illness and paraplegic patients shall not be transferred to other provinces for treatment.
(3) For patients in serious condition, hospitals should send escorts and bring first-aid medicines with them. It is estimated that those who may have life-threatening illnesses on the way cannot be transferred to other hospitals, and they should be kept in hospitals for disposal, and then transferred to other hospitals when their conditions are stabilized, and the patients and their family members should actively cooperate with the hospitals as well.
(4) When transferring to the hospital, you should bring a summary of your medical record, and X-rays and other medical information should be brought with you to avoid duplication of tests and reduce costs. You can borrow them and return them to the hospital when you are discharged at the end of the treatment.
(5) The transfer of patients to other departments within the hospital is subject to the consent of the transferring department and the decision of the medical department if necessary. The transferring department will send someone to send the patient to the transferring department, and hand over the condition of the patient and explain the relevant matters. The transferring department will follow the same procedures as the newly admitted patients, write the transfer record, and notify the outpatient clinic and the nutrition department.
4, for the transfer of the transfer procedures for a few points:
(1) the transfer of the transfer of approval for nine days, from seven days before the date of hospitalization to 48 hours after the date of hospitalization, more than should be re-approval procedures. Those who have been hospitalized for more than one month should inform the Huangling County Social Insurance Administration Center.
(2) For patients with critical or emergency conditions, they can be referred to the hospital first, and the referral and transfer procedures shall be reapproved within 48 hours after the date of hospitalization. Due to the limitations of medical technology and diagnostic and therapeutic equipments of the transferring hospital, those who need to be transferred to other hospitals in or outside the province for treatment for the second time should inform the Municipal Health Insurance Office within 48 hours, and at the same time should have the referral certificate of the transferring hospital, otherwise, the medical expenses incurred will not be reimbursed by the health insurance fund.
(3) The medical expenses incurred will not be reimbursed by the medical insurance fund if they are not approved and not communicated to the Social Insurance Administration Center of Huangling County within the specified time limit.