Beijing medical insurance hospitalization reimbursement ratio

The hospitalization reimbursement rates of Beijing Health Insurance are as follows:

1. The reimbursement rate of community health service institutions is 80%;

2. The reimbursement rate of first-class hospitals is 80%;

3. The reimbursement rate of second-class hospitals is 75%;

4. The reimbursement rate of third-class hospitals is 70%.

Starting standard for hospitalization:

1. Starting standard for community health service institutions: 300 yuan;

2. Starting standard for category 1 hospitals: 500 yuan;

3. Starting standard for category 2 hospitals: 800 yuan;

4. Starting standard for category 3 hospitals: 1,000 yuan.

Medicare reimbursement materials:

1, ID card;

2, social security card;

3, stay hospitalization medical cost invoices;

4, hospitalization cost summary list of the original;

5, the first page of the medical case;

6, discharge summary;

7, summary list of the cost;

8, cost receipts. p>8, cost receipts;

9, outpatient (emergency) medical records and examination reports (outpatient emergency required);

10, pathological examination reports;

11, surgical records;

12, long-term and temporary medical orders;

13, other required information.

Medical insurance reimbursement process:

1, in the medical insurance designated hospitals

Every city has a medical insurance designated hospitals, only in the medical insurance designated hospitals, can use the medical insurance to reimbursement. So if you want to use the medical insurance, you must go to the medical insurance designated hospitals, and to handle the relevant registration procedures;

2, ready to discharge information

In the discharge of the hospital in advance to the discharge of information to prepare, such as the diagnosis of the disease, the discharge record and the medical record, and so on. The doctor will help us to prepare these documents if we tell him that we need them during the treatment, and it is better to make a copy of these documents after you get them. One copy will be submitted to the medical insurance reimbursement office, and the other copy will be kept as a backup;

3. Discharge settlement

Take the hospitalization list and the invoice, and go through the settlement procedures in the hospital. After that, you can bring the relevant information to the medical insurance reimbursement department to reimburse and audit;

4, waiting for the reimbursement of expenses to the account

When the information has been handed over, you will receive a receipt, the reimbursement amount will be within 15 days to the account, you just need to wait patiently.

In summary, during the period of enjoyment of health insurance benefits, the insured person is hospitalized in the designated hospitals in the city, the medical expenses are not directly settled in the hospital through the computer network of health insurance, the starting standard of the health insurance fund is in accordance with the standard of the designated medical institutions of the same kind in the city.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses that are in line with the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical services and facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.