Beijing-Tianjin-Hebei medical treatment process in 2023

The medical treatment process in Beijing, Tianjin and Hebei in 2023 is as follows:

1, query the designated medical institutions in different places, and ensure that it can be directly calculated and reimbursed by the hospital. Log on to the national social insurance public service platform and inquire about the "designated medical institutions in different places" that can be directly settled;

2. The employer where the insured person is located (the useless unit insured person is handled by the street social security office) holds the social security card of the insured person (hereinafter referred to as the social security card) to the medical insurance agency to which the insured person belongs to handle the "hospitalization card activation" procedure of the social security card. Insured persons with social security cards who go through hospitalization settlement procedures in Beijing do not need to go through the "hospitalization card activation" procedure;

3. filing. The insured unit holds the Registration Form for Direct Settlement Filing in duplicate and the social security card of the insured person to submit the application for direct settlement filing of the insured person for medical treatment in different places to the social security agency. Interpretation: For the sake of insurance, it is recommended that the insured or agent bring their own identity documents, the insured social security card and two registration forms for filing in different places;

4. After the direct settlement of hospitalization expenses in different places is completed, it will take effect the next day.

Scope and standard of medical treatment in different places:

1, direct settlement of hospitalization medical expenses, implementation of the prescribed scope of medical treatment payment and related regulations (basic medical insurance drug list, medical service facilities scope and diagnosis and treatment items);

2, the medical insurance fund Qifubiaozhun, payment ratio, maximum payment limit and settlement period. Implement Beijing medical insurance policy;

3. For the expenses directly settled in medical insurance coverage, calculate the daily average cumulative treatment.

To sum up, the insured person goes to the designated medical institution for medical treatment in different places for direct settlement and filing, and goes through the relevant procedures for medical treatment. When handling admission registration, discharge settlement and other procedures, you need to take the initiative to show your social security card and seek medical treatment under your real name.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.