Fushun City, how to apply for medical treatment in a different place

Special Note: The record of medical treatment in other places is for the medical expenses incurred by hospitalization. Urban workers with individual accounts can use their individual accounts in the national network of outpatient clinics or pharmacies, without any record.

1. How many types of medical records are there? What are the conditions to be met for the record of medical treatment in a different place?

A: The record is divided into two categories: temporary medical treatment and long-term medical treatment (including relocation).

Temporary out of the record personnel: through the "Fushun health insurance" WeChat public number to do temporary medical self-service record, or to the city health insurance center window to provide ID cards and medical place for the record.

Long-term foreign medical record personnel are divided into three cases, need to meet the conditions are as follows:

(1) participate in the Fushun City basic health insurance retirees, urban and rural residents reached the age of 60 years of health insurance participants: to provide their own foreign household registration, foreign real estate certificate or foreign residence certificate of any one of the materials, together with a valid ID card or social security card can be handled for the record of long-term foreign medical care.

(2) resident staff:

1 really need to work by the employer unit stationed in a different place to work for more than half a year of active employees, the employer to the health insurance center window for: need to provide proof of work in a different place (participation in the workplace work unit sent to prove that the work unit certificate, proof of the work unit in a different place, the work contract to choose any one).

2 flexibly employed workers health insurance employees or urban and rural residents under the age of 60 years of health insurance participants: need to provide proof of work in a different place and their residence permit.

3 choose their own career military personnel: to provide their own foreign household register, foreign real estate certificate or foreign residence certificate of any material, together with a valid ID card or social security card can be resident in a different place for the record of the staff.

(3) Minor urban and rural residents health insurance participants: need to provide themselves and their guardian ID card, guardianship statement (birth certificate, etc.), guardian of the local employees to participate in the health insurance certificate or the guardian has been resident in a different place for the staff of the foreign medical record.

Special note: Long-term foreign medical record staff can not apply for the record during the hospital, otherwise it will lead to the normal settlement of hospitalization costs.

2. temporary out of the medical treatment of what circumstances need to be filed to the provincial level? What is the difference between filing in Shenyang City and the provincial level?

Generally, it is provincial hospitals and specialized hospitals in Shenyang City that need to be filed to the "provincial level", and when filing on WeChat, a dialog box will pop up prompting the need to file a list of hospitals at the provincial level.

If you choose "Shenyang City" as your place of residence by mistake, you will not be able to pay for some special high-value medicines, or you will not be allowed to complete some treatments during your hospitalization, and thus you will not be able to pay for them with your card, so we recommend that you read the tips in detail and choose the correct place of residence. If you need to cancel, please contact the medical insurance center in time, after the cancellation of the applicant needs to be re-filed.

3. What is the reason for not being able to settle the bill in a different location even though it is correctly filed?

(1) did not use a valid Fushun City, the second generation of the social security card, you need to confirm the activation of the use of the card;

(2) in the hospitalization of the record, you need to do in the hospital after the transfer of self-funding health insurance, before the card settlement;

(3) repeat hospitalization, the last hospitalization did not handle the discharge registration, the next hospitalization;

(4) other: please call the health insurance hotline 024-55883333, provide information about the hospitalization, the hospitalization of the next hospitalization;

(4) Other: please call the health insurance hotline 024-55883333, provide information about the hospitalization of the next hospitalization;

(6) the hospitalization of the first two years of the hospitalization of the first two generations of social security cards. 55883333, provide a picture of the computer error that cannot be settled, and the specific problem will be reported by the medical insurance center to the software engineer to solve.

4. When the reimbursement of expenses to the account, in that department can check, what procedures to bring?

Under normal circumstances, the manual reimbursement of incidental claims will be paid within 30 working days from the date of acceptance.

Under normal circumstances, the manual reimbursement of incidental claims will be paid within 30 working days from the date of acceptance.

Special note: Individual banks may have blocked transactions within half a year, resulting in reimbursements not being credited smoothly. Therefore, please make sure that your bank card is working properly before submitting your documents. If you do not confirm the normal use of your bank card, please go to the counter of your bank branch to make a deposit transaction and receive the deposit vouchers before going to the window of the medical insurance to make a manual reimbursement.

5. What should be done for those who are eligible for "relocation"?

There are two ways to handle the relocation: (1) window processing; (2) cross-provincial relocation business can be self-service through the "national record of relocation of WeChat micro-program".

The materials that need to be submitted are: (1) a copy of the real estate license of the place of settlement, the household register, the residence permit of any one of the three; (2) a copy of the ID card.

6. Urban and rural residents health insurance, urban workers health insurance, how to apply for reimbursement, what procedures are required?

To apply for manual reimbursement of hospitalization expenses need:

(1) complete hospitalization records (2) hospitalization receipts (3) detailed list of hospitalization expenses

(4) Fushun Bank, or the Bank of China, or a copy of the Bank of China card can be

(5) the recent bank card water vouchers (in order to ensure that the bank card for the activation of the state, to prevent the inability to successfully enter the account.)

7. Are the medicines produced by the hospitalization in a different place covered by the medical insurance?

The direct settlement of medical treatment in a different place carries out the scope of payment and relevant regulations, and the manual reimbursement of medical expenses for medical treatment in a different place carries out the scope of payment and treatment policy of the insured place.

8. After the relocation, if you are hospitalized outside of the relocation area, how will you be reimbursed? What is the percentage?

The people who are resettled in a city other than the place of resettlement are required to do temporary out of the city for the record (in the "Fushun health insurance" WeChat public number or the window of the health insurance center for the record), in the city of the record with the electronic vouchers of the health insurance or Fushun second-generation social security card for direct settlement, and reimbursement ratio is equivalent to the reimbursement of the people who temporarily travel to a different place for medical treatment (Note: The card is not available in the place of participation in the insurance. In the insured place can not be realized with the card settlement, must go to the window of the health insurance center manual settlement), reimbursement ratio: urban workers 55%, 45% of residents.

9. The relocation of people who want to resettle the medical insurance relationship back to the place of residence, how to apply for procedures? Is there a time interval?

Retirees, long-term residents and permanent staff residing in a different place are entitled to a long-term record of medical treatment in a different place, which cannot be changed or canceled for at least 6 months. The person who wants to cancel the relocation only needs to provide his ID card to the window of the medical insurance center to apply for cancellation, which will take effect immediately on the same day.

10. What is the threshold for medical treatment in a different location? The threshold fee for re-admission to the hospital is still charged?

The threshold fee for temporary medical treatment in a different place is 3,000 RMB per visit, and the threshold fee is charged once for each hospitalization.

11. The medical treatment in a different place has been filed, can also be connected to the Internet, but the settlement of the overall zero or reimbursement amount deviation is too large how to do?

If it is zero, it is possible that the total hospitalization cost does not reach the threshold of 3000 RMB.

If the reimbursement amount deviates too much, it may be due to the wrong choice of place of medical treatment when filing, which may result in the high value drugs not being able to be settled with the card, so it is necessary to correctly file the record, communicate with the hospital, adjust the category of medical treatment, and re-settle the bill.

12. Can I be reimbursed for pre-hospital emergency care when I go out temporarily? Hospitalization starting standard and reimbursement rate is how much?

A: October 1, 2021 onwards, the implementation of the "basic medical insurance on the adjustment of the basic medical insurance payment policy" (Fu medical insurance hair [2021] No. 9), the abolition of the system of referrals to hospitals in different places, to adjust the policy of payment of medical treatment in different places.

In addition to the relocation of personnel, participants in the city outside the medical institutions (including relocation of personnel to the relocation of medical treatment outside) hospitalization and pre-hospital emergency medical expenses to October 1, 2021 onwards, the starting standard adjusted to 3,000 yuan / person, urban and rural residents reimbursement of participants for 45% of the overall costs, urban workers reimbursement of participants for 55% of the overall costs. The reimbursement rate for urban and rural residents is 45%, and that for urban employees is 55%. One of the pre-hospital emergency rescue including the following three cases: 1 cure discharge 2 hospitalization after stabilization 3 rescue invalid death.

Since February 1, 2022, the city's insured persons temporarily out of the medical (including relocation of personnel to relocation outside the medical), provide the applicant's identity card and medical treatment, through the "Fushun medical insurance" WeChat public number or to the window of the medical insurance center for the record, you can achieve the immediate settlement of the card for medical treatment in a different place. Not in accordance with the provisions of the record, out-of-pocket advances back to the agency manual reimbursement, the basic health insurance fund reimbursement rate down by 10%, that is, 45% for urban workers, urban and rural residents for 35%.

The filing for resettlement and temporary hospitalization is for those who need hospitalization in a different place, and the applicant must file the record before admission, otherwise it will affect the settlement of hospitalization expenses in a different place with a card.

13. What are the documents required for manual reimbursement for relocation and temporary out-of-town medical treatment?

A: The original complete hospitalization medical records, original hospitalization receipts, original hospitalization cost list, a copy of the patient's second generation medical insurance card to open the Fushun Bank card function, if not the new medical insurance card to provide the patient's account Fushun Bank card, construction bank card or a copy of the Bank of China card.

14. outpatient manual reimbursement of special diseases in other places, what are the materials required?

A: the original outpatient receipt, the original outpatient cost list, a copy of the outpatient special chronic disease card, a copy of the patient's second-generation health insurance card to open the Fushun Bank card function, if the new health insurance card is not required to provide the patient's account Fushun Bank card, construction bank card or a copy of the Bank of China card. Note: hemodialysis patients need to provide dialysis records and stamped with the official seal of the hospital; radiation therapy patients need to provide radiotherapy plans and stamped with the official seal of the hospital.

16. How long is the validity of the foreign record? Answer: (1) the relocation of retirees, long-term residents of other places, permanent staff in other places of foreign medical record is valid for a long time, without the need to repeat the record, at least 6 months shall not be changed or canceled, the place of medical treatment or changes in the relationship between the insurance need to be re-applied.

(2) temporary out of the personnel record: the record is valid for 7 working days after the entry into force, the expiration date is not admitted to the hospital participants only need to re-file

17. How to operate the online self-service record of medical treatment in a different place?

Answer: Temporary foreign medical record personnel through the "Fushun health insurance" WeChat public number self-service record or to the city health insurance center window record (Xinbin County, Qingyuan County can go to the local health insurance center window record).

The cross-provincial application for the record of the relocation of personnel, long-term residence in a different place, permanent staff in a different place (excluding the work stationed staff) can be through the "national record of medical care in a different place" WeChat app or the national health insurance service platform APP uploading long-term residence in a different place to apply for the record, you can also go to the window of the municipal health insurance center to apply for the record. For the record (Xinbin County, Qingyuan County can go to the local health insurance center window for the record), can be provided by the chargé d'affaires for a copy of the material for processing.

province to apply for the record of the relocation of personnel, long-term residents of other places, permanent staff stationed in other places have not yet opened the online filing channels, temporarily only to the Fushun City Health Insurance Center window for the record (Xinbin County, Qingyuan County can be filed in the local health insurance center window), can be provided by the agent to provide a copy of the materials for processing.