Social security referral order how to use the process is what

Legal analysis: First, the social security card referral order for the content

Referral is usually the first medical institution to the necessary diagnosis and examination of the patient, to determine the condition, and combined with the diagnostic and treatment capacity of the institution of the next diagnostic and treatment measures for the treatment of a kind of processing advice. If the patient's condition requires referral to a higher level hospital, the first hospital will issue a referral order for the patient. The original intention of the design of the community outpatient clinic is to solve the problems of common and frequent illnesses of community residents through low-level financing, limited health insurance resources and low prices, and to truly realize that the public can enjoy basic outpatient medical care, including prevention and health care, etc., in the communities (villages) they live in and at their doorsteps, and that only the "basic health services" are provided. Only a small number of people suffering from chronic diseases beyond the capacity of the community referral to higher hospitals or specialized hospitals for treatment, thus alleviating the masses "expensive and difficult to see a doctor" problem, and gradually guiding the masses to establish a "minor illnesses in the community, major illnesses to the hospital, rehabilitation back to the community" good concept of medical care. The program gradually guides the public to establish a good concept of medical care. Participants in their community outpatient medical point of care, the attending physician can be based on the condition of the diagnosis and treatment needs, in accordance with the principle of referral level by level for the participants referred to the town (street) designated hospital outpatient department (refers to the hospital's main outpatient clinic) urgent condition, can be directly referred from the service site to the designated specialist hospital outpatient department or the city designated outpatient clinic.

Social security card reimbursement process

Inpatient hospitalization and outpatient treatment of special diseases settlement procedures:

Specified medical institutions in the previous month before the 10th day of each month, will be discharged from the patient's fee statement, hospitalization statement and related information reported to the health insurance agency, the health insurance agency audit, as a monthly preallocation and the end of the year final accounts of the basis for the health insurance agency Monthly advance allocation of the previous month's hospitalization and outpatient treatment of special diseases of the integrated cost of recognized special diseases of the insured should go to a designated medical institutions designated by the Ministry of Labor and Social Security to purchase medicines, medical expenses incurred directly account for the immediate settlement.

Emergency settlement procedures: the insured person due to emergency rescue to the city non-designated medical institutions and foreign medical institutions hospitalization, medical expenses incurred by the individual or the unit advance payment, emergency rescue after the end of the emergency, with the hospital emergency medical records, inspection, laboratory reports, invoices, detailed list of medical charges and so on until the medical insurance agency for reimbursement procedures in accordance with the provisions of the regulations.

The settlement procedure for staff resettled in other places:

The staff resettled in other places shall be assigned 1-2 designated medical institutions in their place of residence by their units and report to the medical insurance agency for the record. The medical expenses incurred by the staff resettled in other places who are sick in the designated medical institutions in their place of residence shall be advanced by themselves or their units, and the medical expenses incurred by the staff resettled in different places shall be advanced by themselves or their units. After the completion of treatment, the unit will hold the participant's medical card and medical records, valid expense notes, duplicate prescriptions, and a list of hospitalization expenses to settle the bill at the social medical insurance agency on the specified date.

Legal basis: The Social Insurance Law of the People's Republic of China Article 4 Employers and individuals in the territory of the People's Republic of China shall, in accordance with the law, pay social insurance premiums, and shall have the right to inquire about the records of premium payment and the rights and interests of individuals, and to request social insurance agencies to provide them with social insurance consulting and other related services. Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise the payment of contributions for them by their own units.