1, with hardware facilities to support the medical insurance card card. For example, pharmacies must install card readers, POS machines and other card-swiping equipment, or be transformed to facilitate the use of medical insurance card card card payment;
2. Pharmacies must have the "Drug Business License" and "Medical Device Business License" and other certificates and licenses, and in accordance with the relevant provisions of the State for the signing of the agreement of the designated unit of the medical insurance;
3. Pharmacies must be enrolled in the medical insurance fixed-point Pharmacy network, and comply with national, provincial and municipal health insurance policies;
4, pharmacies and their employees should understand the health insurance policy, and to participate in the health insurance designated pharmacy training, to ensure that the correct operation and use of the health insurance system;
5, the pharmacy must be in accordance with the requirements of the national, provincial and municipal health insurance departments, to establish sound health insurance management rules and regulations and internal operating procedures, to ensure that the health insurance card swiping The safety and standardization of services.
Medicare reimbursement process:
1, medical treatment: to the hospital or clinic to see a doctor or treatment;
2, payment: in the hospital or clinic to pay their own should pay the medical fees;
3, to get the list of costs: in the process of medical treatment, the hospital or clinic will provide a list of costs, which listed the specific cost of the visit to the medical program and the amount;
4, fill in the reimbursement application form: with the list of expenses, fill in the health insurance reimbursement application form, fill in the need to provide their own basic information, list of medical expenses, medical insurance card and other related information;
5, hand in the information: the completed reimbursement application form and related information to the health insurance agency, you can submit it through the online or offline way;
6, the audit: health insurance The application form and information submitted will be audited by the medical insurance agency. After the audit, the medical insurance agency will credit the reimbursement to the individual's bank account or give cash reimbursement.
To sum up, the conditions for enrollment, contribution standards and reimbursement coverage may vary from region to region and from one health insurance system to another, so residents need to understand local regulations and policies and consult the staff of the local social insurance agency when enrolling in health insurance.
Legal basis:
Article 28 of the Social Insurance Law of the People's Republic of China
Medical expenses that are in line with the basic medical insurance drug list, 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 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administration organization with the medical institutions and drug business units.