How to reimburse the Social Security Bureau for the drugs bought by big pharmacies?

Reimbursement by the Social Security Bureau can only be reimbursed if the insured person takes an external prescription to the designated pharmacy to buy medicine.

The demand of designated pharmacies to buy drugs is that the insured holds a prescription for external use and can only be reimbursed if it meets the requirements of designated pharmacies and prescriptions for external use.

Take Beijing as an example:

Designated retail pharmacies in Beijing can provide basic medical insurance services for the insured. When the insured person shows his prescription and social security card at the designated pharmacy, he can realize the "second report" just like seeing a doctor at the designated hospital.

To realize the real-time settlement of drug purchase in designated pharmacies, doctors need to issue external prescriptions after outpatient (emergency) consultation in designated medical institutions and upload prescription information to the medical insurance information system in real time.

When the insured person goes to the pharmacy to get medicine, he will show his prescription and social security card. Designated retail pharmacies download the prescription information uploaded by designated medical institutions from the medical insurance network, compare the information with the paper prescription, dispense drugs according to the prescription drug information, and use social security cards to settle the drug expenses for the insured.

The insured person only needs to bear the personal burden, and the expenses paid by the medical insurance fund are paid in advance by the designated pharmacies. The reimbursement period of external prescription expenses will be changed from several months to several seconds, and the settlement and reimbursement will be completed in one step, making it more convenient and faster for insured people to buy medicines at designated retail pharmacies.

Extended data

Beijing's designated pharmacies entered the designated list after screening through social insurance integrity information verification, data inspection, on-site inspection, expert review, publicity and consultation.

Insured personnel must hold a card to buy medicine according to regulations. If the card is not issued, the card is damaged, the company owes money, or the card is changed, or the medicine is purchased at a designated retail pharmacy that does not have the credit card conditions, and the external prescription information is not downloaded successfully when purchasing the medicine with the card, the individual still needs to pay the full amount of the medicine purchase, and at the same time, he needs to apply for manual reimbursement before 65438+10.20 of the following year.

Xinhuanet-Beijing: From next week, designated pharmacies can brush social security cards for real-time settlement.