Do emergency claims count as outpatient or inpatient

Emergency claims are considered outpatient.

1, emergency costs can be reimbursed through the health insurance, if the emergency treatment is transferred to inpatient treatment, the emergency medical fees within 7 days before hospitalization can be reimbursed through the health insurance;

2, if the patient in the emergency directly use the health insurance card, the reimbursement rate of emergency medical fees will be reimbursed in accordance with the outpatient rate of the health insurance;

3, when the patient due to the seriousness of the condition need to be turned to hospitalization, has been previously swiped the card according to the outpatient reimbursement rate, the emergency medical expenses can not withdraw from the re-approach according to the rate of inpatient hospitalization.

Social security reimbursement classification:

1, the type of reimbursement: social security is usually divided into outpatient reimbursement and hospitalization reimbursement of medical expenses;

2, reimbursement conditions: outpatient reimbursement and hospitalization reimbursement of the conditions and rates are usually different;

3, reimbursement process: the process of reimbursement of different types of reimbursement may vary, such as the submission of materials and review time;<

4, reimbursement limits: Social Security usually has certain limits and regulations on the amount of reimbursement for outpatient and inpatient hospitalization;

5, special handling: emergency reimbursement may be handled in a special way according to specific policies.

In summary, emergency expenses can be reimbursed through health insurance, but if the emergency is converted to inpatient treatment, the emergency medical expenses that have been previously swiped at the outpatient reimbursement rate cannot be re-processed at the inpatient rate.

Legal basis:

The People's Republic of China*** and the State Social Insurance Law

Article 28

Medical expenses in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical services and facilities, as well as emergency and rescue, shall be paid from the basic medical insurance fund in accordance with state regulations.