How to open the medical insurance settlement

Medicare settlement is opened as follows:

One is the first record. Before the insured person cross-provincial medical treatment, through the national health insurance service platform APP, the national medical treatment record small program, the State Council client small program or the insured place of the agency window and other on-line and off-line ways to deal with the record of medical treatment.

The second is to choose a point. After completing the record of medical treatment in a different place, the insured person can enjoy the direct settlement of hospitalization expenses in all the inter-provincial networked designated medical institutions opened in the place of filing outpatient medical treatment, you need to understand the management regulations of the place of insurance for medical treatment in a different place, and if the place of insurance requires the insured person to choose a certain number of inter-provincial networked designated medical institutions for medical treatment and purchase of medicines in a specified level, it will be carried out in accordance with the regulations of the place of insurance.

Third, the code card for medical treatment. Participants in the hospital registration, discharge settlement and outpatient settlement are required to show the health insurance electronic voucher or social security card and other valid vouchers. The cross-provincial network of designated medical institutions to meet the provisions of the place of treatment outpatient (emergency) clinics, hospitalized patients, to provide reasonable and standardized diagnosis and treatment and direct settlement of medical expenses.

The process of medical insurance reimbursement for medical treatment in other places is as follows:

1. Receive or download from the social security website the "Municipal Basic Medical Insurance Reporting Form for People Working and Residing in Other Places" (hereinafter referred to as the "Reporting Form");

2. Fill in the Reporting Form according to the regulations and have the seal recognized by the social insurance (medical insurance) agency of the other place;

3. Fill out the "Declaration Form" and take it back to the social insurance agency in charge of the division of labor to review and confirm. For those who are required to apply for a medical card in a different place in the province, they should go to the Audit Section of the Municipal Social Security Center to register with the "Declaration Form" after the audit and confirmation, and then go to the Social Security Card Management Section to apply for the card-making procedures of the province's networked cards in a different place;

4. The individual social security cards of the insured persons cannot be used after the preparation; if the insured persons return to the city where they are required to seek medical treatment, they should go to the Municipal Social Security Institution to cancel the medical preparation and the individual social security card can be used in the designated medical treatment center only from the next day onwards. Social security card can only be used in the designated medical institutions;

5, the implementation of medical reporting changes in the report, the principle of non-reporting without change.

In summary, medical insurance reimbursement refers to a system of reimbursement of expenses through medical insurance organizations after medical treatment in a place other than the place of residence.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 28

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.