How to reimburse Beijing social security card for medical treatment?

How to reimburse Beijing social security card for medical treatment?

Social insurance refers to a social and economic system that provides income or compensation for people who lose their ability to work, are temporarily unemployed or suffer losses due to health reasons. The following is how to reimburse Beijing social security card for medical treatment. I hope you like this article!

How to reimburse Beijing social security card for medical treatment?

Unbound medical institutions must show their social security cards when registering for medical treatment. If the expenses exceed 1800 at the time of settlement, the hospital will automatically eliminate the reimbursement part and only pay the expenses that the individual should bear.

Manual reimbursement reporting process of basic medical insurance for urban employees in Beijing

Treatment conditions:

1, the expenses incurred during the period when the new insured fails to issue the social security card;

2, in the designated medical institutions without card emergency medical expenses;

3. Report the loss of the social security card and reissue the expenses incurred during the medical treatment of the social security card;

4. Expenses incurred during the period of manual reimbursement for medical treatment;

5. Medical expenses during the default period;

6, no maternity insurance personnel cost of family planning surgery;

7, in accordance with the provisions of the city's medical insurance in other places of medical expenses;

8, in line with the provisions of medical insurance, the cost of drugs purchased in this city.

Handling materials:

1, social security card;

2. Detailed list of expenses for manual reimbursement of basic medical insurance in Beijing or detailed list of expenses uploaded by outpatient service of basic medical insurance in Beijing;

3, "Beijing Medical Insurance Manual Reimbursement Expense Audit Form" or "Beijing Medical Insurance Outpatient Upload Expense Audit Form";

4. Charge bills;

5. The underlying prescription;

6, check, treatment cost details;

7. Offer documents;

8. Emergency diagnosis certificate (any of the following can be used: emergency prescription stamped by emergency department (room), special prescription stamped by Beijing Medical Insurance and emergency diagnosis certificate);

9, Beijing medical insurance referral (hospitalization) list.

At the same time, provide materials that meet the handling conditions, such as:

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

2, the arrears issued by the unit and stamped with the official seal;

3. Copy of diagnosis certificate and marriage certificate of family planning operation (retirees do not need to provide it);

4, the city's medical insurance designated pharmacies receipts and expense details, stamped with the special seal of designated medical institutions prescription;

5. Trauma description needs to be stamped with the official seal of the employer/social security office.

operation sequence/order

1. The insured unit/social security office receives the medical expense documents declared by the insured, inputs the medical expense information through the collection software, keeps the social security card, and submits the social security card and application materials to the district (county) medical insurance agency in time;

2, the district (county) medical insurance agencies to complete the audit and settlement work in a timely manner;

3. The insured unit/social security office shall promptly notify the insured to retrieve the social security card and reimbursement results that have been audited and settled.

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