Who can see a doctor in a different place and pay directly by card?
Direct settlement of medical treatment in different places shall be registered for the record, and the scope of direct settlement of medical treatment in different places includes:
1. Resettlement of retirees in different places: refers to those who have participated in the basic medical insurance for urban workers in our city (including medical insurance for flexible employees), enjoyed the medical insurance benefits for retirees and moved into their places of residence.
2. Long-term residence in different places: (1) Persons who participate in the basic medical insurance for urban workers and urban and rural residents in our city, live in different places and obtain residence permits issued by public security organs. (2) College students who participate in the basic medical insurance for urban and rural residents in our city (that is, "two cities and one family" college students).
3. Resident staff in different places: those who participate in the basic medical insurance for urban workers in our city and are sent by the employer to work and study in different places for a long time.
4. Referral personnel from different places: those who participate in the basic medical insurance for urban workers and urban and rural residents in our city and go through the procedures of referral and transfer in designated medical institutions with referral qualifications in our city. Q49 Is there a deadline for filing medical information in different places?
Long-term filing information of long-term residents in different places is valid for a long time after approval and will not change. Can Q50 mobile phones be archived in different places?
Of course. Filing in different places outside the province can be handled through the "National Medical Insurance Service Platform" APP or "Heilongjiang Government Service Network"; Filing in different places in the province can be handled by following WeChat official account "Longjiang Medical Insurance" or "Qiqihar Medical Security Bureau" or "Personal Network Hall of Heilongjiang Medical Insurance Service Platform". Handling process: (1) National Medical Insurance Service Platform APP: download the real-name authentication of National Medical Insurance Service Platform APP by mobile phone and log in-online processing-off-site filing-off-site filing application-select "myself filing" or "others filing"-select Qiqihar City, Heilongjiang Province as the insured place-select the insured type-read quickly. Tick the notice that I have carefully read the filing-I have read it and started filing-select "application filing start date" (at most 5 days in advance)-fill in the contact information-upload the materials (front and back of the residence permit within the validity period of the medical treatment place; Proof of residence in a medical place stamped with the official seal of the public security organ; The first page and personal page of the household registration book that has moved to the medical treatment place; Certificate of long-term work and study in different places in Qi City issued by the employer)-submission for record-confirmation-audit is expected to be completed within two working days after the filing information is successfully submitted.
(2) Heilongjiang government service network: open the "Heilongjiang government service network" webpage in the computer or mobile browser, and select "Qiqihar City, Heilongjiang Province" in the login-switching region and department. The municipal department selects "Municipal Medical Insurance"-selects the filing type (filing for permanent residents in different places or filing for long-term residents in different places or filing for retirees in different places) in the list of matters of the Municipal Medical Insurance Bureau-clicks on online processing-clicks on reading instructions Next-"You know the approval conditions and materials to be prepared for handling this matter" Click OK-fill in the basic information-collect materials and click on the attachment (front and back of the residence permit within the validity period of the medical treatment place; Proof of residence in a medical place stamped with the official seal of the public security organ; The first page and personal page of the household registration book that has moved to the medical treatment place; Certificate of long-term work and study in different places in Qi City issued by the employer)-Submit-"Commitment: I promise to have the above application conditions and materials, and the application conditions and materials are absolutely true!" Click OK-the review is expected to be completed within two working days after the application information is submitted successfully.
(3) Official account of Longjiang Medical Insurance: Mobile WeChat pays attention to Longjiang Medical Insurance in the official account of WeChat-click on the service hall in the lower left corner-click on "I want to do it"-click on "filing in a different place"-select "filing by myself" or "filing by others"-click on "confirmation information"-select the filing type-select the medical treatment place- Proof of residence in a medical place stamped with the official seal of the public security organ; The first page and personal page of the household registration book that has moved to the medical treatment place; Certificate of long-term work and study in different places in Qi City issued by the employer)-Submit the declaration-It is expected that the audit will be completed within two working days after the filing information is submitted successfully.
(4) The process of the official WeChat account of Qiqihar Medical Security Bureau is the same as that of the official WeChat account of Longjiang Medical Insurance.
(5) Heilongjiang Medical Insurance Service Platform Personal Web Hall: open the #/index in the computer browser, select Personal Web Hall to log in-enter Personal Web Hall-I want to do it-file for medical treatment in different places-select "file for myself" or "file for others"-fill in the filing information, select the filing type-select the medical treatment place-select the filing start date (up to 5 days in advance)-click and sign the letter of commitment-upload the materials (. Certificate of long-term work and study in different places issued by the employer in enterprises and cities)-Submit-Check that I have read and agreed and click-After the filing information is submitted successfully, it is expected that the audit will be completed in two working days. Q5 1 If the insured person in our city needs to be transferred to Beijing and other cities for medical treatment due to illness, how to go through the formalities? Referral and referral process: experts from clinical departments of designated medical institutions with referral qualifications put forward referral suggestions, fill in the application form for in-hospital referral and referral, and submit it to the medical insurance department of the hospital for review. The medical insurance department will do a good job of referral and referral in the medical insurance system for the insured who meet the requirements of the referral and referral documents, and put on record in the cities that need to be transferred.
Medical institutions that can handle referral:
Municipal level: Qiqihar First Hospital, First Affiliated Hospital of Qiqihar Medical College, Second Affiliated Hospital of Qiqihar Medical College, Third Affiliated Hospital of Qiqihar Medical College, Qiqihar Traditional Chinese Medicine Hospital, Qiqihar Jianhua Hospital, China People's Liberation Army Joint Logistics Support Force No.961Hospital, Aier Eye Hospital, Qiqihar Tuberculosis Prevention Hospital, Qiqihar Seventh Hospital, Qiqihar Mental Health Center and Qiqihar Ankang Hospital.
Fuyu County: Fuyu County People's Hospital and Fuyu County Chinese Medicine Hospital.
Tailai County: Tailai People's Hospital and Tailai Chinese Medicine Hospital.
Baiquan County: Baiquan County People's Hospital and Baiquan County Chinese Medicine Hospital.
Keshan County: Keshan County People's Hospital, Keshan County Hospital of Traditional Chinese Medicine, Keshan County Hospital of Integrated Traditional Chinese and Western Medicine, and Keshan County Jianyi Hospital.
Yi 'an County: Yi 'an County People's Hospital, Yi 'an County Hospital of Traditional Chinese Medicine and Yi 'an County Center for Disease Control and Prevention.
Longjiang County: First People's Hospital of Longjiang County, Second People's Hospital of Longjiang County, Maternal and Child Health Hospital of Longjiang County, Xinmingyuan Psychiatric Hospital of Longjiang County, Tuberculosis Prevention Institute of Longjiang County, and Longjiang County Hospital of Traditional Chinese Medicine.
Kedong County: Kedong County People's Hospital and Kedong County Chinese Medicine Hospital.
Gannan county: gannan county People's Hospital and gannan county Hospital of Traditional Chinese Medicine.
Nehe city: nehe city People's Hospital and nehe city Hospital of Traditional Chinese Medicine.
Meris District: After Q52, a designated hospital in Meris District, handles the off-site filing or off-site referral filing, how can medical expenses and medical insurance incurred in off-site be reimbursed?
After long-term residence in different places, resettlement in different places, work in different places or successful referral to another hospital for the record, the insured can be hospitalized or treated in different places with his social security card. After the treatment, he can brush his social security card in the hospital in different places for direct settlement. Individuals only need to pay their own medical expenses without going back to our city for reimbursement. The reimbursement rate of medical expenses incurred by off-site filing personnel is the same as that of the corresponding hospitals in our city; Referral and transfer personnel shall pay 10% in advance in the province and 15% outside the province, and then write off according to the reimbursement ratio of tertiary hospitals in our city. If it cannot be settled directly in different places due to system failure, social security card damage and other reasons. Related reimbursement materials can be submitted to the medical insurance service window of each government affairs hall in our city for background reimbursement. Q53 has filed the information of long-term residence in different places, but there is an error in the information when swiping the card for admission (or settlement) in a different hospital. What should I do?
For those who have gone through the record of medical treatment in different places, if there is information error for various reasons when they are hospitalized in different places or settle their expenses, they can call 0452- 12393 to inquire and contact the staff of relevant departments to coordinate the handling. If it still can't be solved, you can pay in advance at your own expense, and bring reimbursement materials to the medical insurance service window of the government affairs hall in each district to apply for reimbursement after you come back. Q54 Which hospitals in other places can directly swipe their cards for hospitalization?
At present, all designated hospitals in different places that enter the national medical insurance direct settlement platform for medical treatment in different places can directly swipe their cards for hospitalization. Please check the designated hospital where you live in the national medical insurance direct settlement APP. Q55 was hospitalized at the emergency rescue site. How to reimburse medical insurance?
Emergency rescue of hospitalized personnel at the scene needs to bring relevant elements for reimbursement:
(1) Original bill for medical expenses settlement (the seal of the bill should be clear and effective);
(2) Cost summary details (stamped with the special seal of the hospital);
(3) A complete copy of the inpatient medical record (stamped with the special seal of the hospital);
(4) I have opened a social security card (or a debit card of my bank) with banking financial function.
For the medical information that has been filed in different places, if it cannot be directly settled by credit card in different places for special reasons, you can also apply for reimbursement with the above elements (the diagnosis certificate can replace the medical record). Q56 For the insured who has not filed medical information in different places and has no indication of emergency hospitalization, are medical expenses incurred in different places reimbursed by medical insurance?
If the insured person has not filed medical information in different places and has no indication of emergency hospitalization, the hospitalization expenses incurred in different places can be reimbursed according to the regulations, that is, the expenses within the scope of medical insurance policy are paid by the individual in advance by 30%, and then written off according to the reimbursement ratio of the tertiary hospital in the insured place. You need to bring relevant requirements to the medical insurance service window of the government affairs hall in each district for reimbursement. Requirements include: (1) original bill for medical expenses settlement (the seal of the bill must be clear and effective);
(2) Cost summary details (stamped with the special seal of the hospital);
(3) the diagnosis certificate (stamped with the special seal of the hospital);
(4) I have opened a social security card (or a debit card of my bank) with banking function. Q57 How to reimburse insured residents for hospitalization after long-term medical treatment in different places?
When the insured residents need hospitalization due to illness, they can directly seek medical treatment in different places designated by the state and the province with their social security cards, and directly swipe their cards to handle hospitalization procedures and implement relevant treatment. When medical expenses within the scope of medical insurance that meet the requirements of the medical treatment place occur, they shall be written off in accordance with the reimbursement ratio specified by the insured place. The settlement method is to implement "one-stop" reimbursement of basic medical insurance and serious illness insurance in hospitals, and individuals only need to pay their own expenses. Q58 How to reimburse the expenses of radiotherapy and chemotherapy in different places for insured malignant tumor patients?
If the insured malignant tumor patient needs radiotherapy or chemotherapy after diagnosis and treatment in different places, please provide the agent with relevant documents for diagnosing malignant tumor and implementing radiotherapy and chemotherapy, such as hospitalization medical records, pathological reports, radiotherapy and chemotherapy plans recorded by doctors, etc. And the agent shall apply for the identification of outpatient special disease (treatment) treatment in the medical insurance department of the second-level or third-level general hospital in Qi City and register it in the medical insurance system, and then the corresponding treatment can be implemented in a hospital in a different place. After the treatment, apply for write-off at the medical insurance service window of each government affairs hall with the reimbursement materials. The reimbursement requirements are as follows:
(1) Original bill for medical expenses settlement (the seal of the bill should be clear and effective);
(2) Cost summary details (stamped with the special seal of the hospital);
(3) the diagnosis certificate (stamped with the special seal of the hospital);
(4) Copy of radiotherapy record sheet or outpatient record manual of chemotherapy treatment plan;
(5) I have activated my social security card (or a debit card of my bank).