1. On admission: the medical insurance patient goes through the social security registration formalities with his ID card, and then goes to the ward for hospitalization;
2. When leaving the hospital: the doctor arranges the patient to leave the hospital, and handles the discharge settlement procedures with the admission registration form and ID card. At present, the reimbursement process has been simplified, and patients do not need to go to the social security center for reimbursement, but can settle accounts directly at the hospital.
Scope and standard of medical insurance reimbursement:
1. Drugs are divided into Class A, Class B and Class C, among which Class A drugs are necessary for clinical treatment and widely used, and the drug expenses of such drugs are reimbursed according to the proportion stipulated by medical insurance. Class B drugs are paid a certain proportion first, and then reimbursed according to medical insurance. The specific reimbursement ratio varies from place to place.
2, diagnosis and treatment project refers to the hospitalization, the use of medical instruments, equipment and medical materials, mainly in two ways, the whole project is included in the scope of medical insurance reimbursement, according to the provisions of the proportion of payment. As a whole, part of the project is paid in advance, and then reimbursed according to the prescribed proportion;
3, medical service facilities standards, refers to the hospital bed fees, outpatient and emergency observation bed fees, etc., the scope and standards of reimbursement vary from place to place. In terms of social security, the scope of medical insurance reimbursement is the items in the medical insurance catalogue, including medicines, medical treatment items and medical service facilities.
To sum up, fever patients should go to the fever clinic, and fever patients who go to community clinics will be asked to go to the fever clinic. However, because the fever clinic can't directly reimburse social security, fever patients should first write a referral to the community clinic and then go to the fever clinic.
Legal basis:
People's Republic of China (PRC) social insurance law
second
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.