The reimbursement process of Shenzhen social security clinic in different places

What is the reimbursement process of Shenzhen social security clinic in different places?

Shenzhen social security outpatient reimbursement process is as follows

Filing: Insured persons need to file medical treatment in official website, Shenzhen Social Insurance Fund Administration, fill in relevant information and submit filing application. Designated medical institutions should be selected when filing, and the validity period of filing should be determined.

Medical treatment: the insured person needs to go to the designated medical institution for outpatient treatment, and the medical expenses incurred can be directly settled online.

Settlement: Insured personnel need to settle accounts according to the scope and standards stipulated by Shenzhen Social Insurance Fund Administration, and different levels of hospitals have different reimbursement rates.

Audit: The medical expenses to be reimbursed need to be audited by Shenzhen Social Insurance Fund Administration, and the amount of reimbursement can only be obtained after the approval.

Payment: After approval, the reimbursement amount will be paid directly to the insured's bank account.

It should be noted that the reimbursement rate of social security outpatient service in Shenzhen will be lower than that of local medical treatment in Shenzhen. At the same time, different levels of hospitals, different drugs and treatment projects have different reimbursement regulations and restrictions.

To sum up:

The reimbursement process of Shenzhen social security outpatient service in different places includes filing, medical treatment, settlement, review and payment. The insured person needs to go to official website, Shenzhen Social Insurance Fund Management Bureau, to the designated medical institutions for outpatient treatment. The medical expenses incurred can be directly settled online, but the reimbursement rate will be lower than that of local medical treatment in Shenzhen. Different levels of hospitals, different drugs and treatment projects, reimbursement regulations and restrictions are different.

Legal basis:

Article 29 of the Social Insurance Law of People's Republic of China (PRC) stipulates: "The part of the insured's medical expenses that should be paid by the basic medical insurance fund shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units."

Article 62 of the Measures for Social Medical Insurance in Shenzhen stipulates: "If the insured person goes to the city for medical treatment, the medical expenses that meet the requirements can be reimbursed according to the regulations."