Manual reimbursement process of Beijing medical insurance

You go to the county medical insurance agency for manual reimbursement every month 1-20, and the relevant information is submitted by the insured unit.

1. Materials required for manual reimbursement include:

(1) social security card;

(2) Detailed list of manual reimbursement expenses of Beijing basic medical insurance or detailed list of uploading expenses of Beijing basic medical insurance outpatient service;

(3) Beijing Medical Insurance Manual Reimbursement Expense Audit Form or Beijing Medical Insurance Outpatient Expense Upload Audit Form;

(4) bill of charges;

(5) the underlying prescription;

(6) Detailed examination and treatment expenses;

(7) Offer documents;

(8) Emergency diagnosis certificate (any of the following can be used: emergency prescription stamped with emergency seal, special prescription for Beijing medical insurance stamped with emergency seal, and emergency diagnosis certificate);

(9), Beijing medical insurance referral (hospitalization) list.

2, at the same time provide materials that meet the requirements, such as:

(1) Copy of receipt of Beijing social security card issuance or business receipt of Beijing social security card or copy of social security card certificate of new card or replacement card;

(2) The unit shall issue a description of the arrears and affix its official seal;

(3) a copy of the diagnosis certificate and marriage certificate of family planning operation (retirees do not need to provide rings);

(4) The receipt and expense details of the designated medical insurance pharmacies in this Municipality shall be stamped with the prescriptions of the designated medical institutions;

(5) The description of trauma needs to be stamped with the official seal of the employer/social security office.

According to the relevant regulations of medical insurance, both the insured unit and the social security office can submit the medical expenses declared by the insured person to the county medical insurance agency for manual reimbursement from/kloc-0 to 20 every month. After the declaration, you will get a medical expense declaration receipt, which takes 15 working days. After that, you can get the Audit Form of Manual Reimbursement of Basic Medical Insurance in Beijing and the Detailed List of Settlement and Payment from the Medical Insurance Center with the receipt.

Extended data:

These situations are not reported by medical insurance:

Even if you apply for manual reimbursement, it does not mean that all medical expenses can be reimbursed. Because according to the regulations of medical insurance, there are many situations that are not within the scope of reimbursement. This includes:

1, see a doctor in a non-designated medical institution, except emergency (emergency can be seen in any designated medical institution);

2. Buy medicines at non-designated retail pharmacies;

3. Injuries caused by traffic, medical treatment or other accidents; If the insured goes to the designated medical institution for medical treatment due to traffic or other accidental injuries, and can provide the relevant written proof that the responsible party escapes or cannot find the responsible person issued by the security department, his medical expenses can be included in the payment scope of the medical insurance fund; Unable to provide such written proof, the medical insurance fund will not pay medical expenses.

4, I take drugs, fighting or other illegal acts causing harm;

5, due to suicide, self-mutilation, alcoholism and other reasons to receive treatment;

6. Receiving treatment abroad or in Hongkong, Macao Special Administrative Region and Taiwan Province Province;

7, according to the provisions of the state and the city should be paid by individuals.

Source: People's Health Network -8 cases can apply for medical insurance manual reimbursement.