How to reimburse Beijing medical insurance clinic?

Beijing medical insurance outpatient reimbursement process is as follows:

1. The insured persons bring the Beijing Medical Insurance Manual with barcode to the designated medical insurance hospital for treatment;

2. The designated hospitals for medical insurance should check the handbook of the insured, collect the basic information of the insured through the barcode on the handbook, issue the medical expense documents issued by the emergency department, and upload the outpatient expenses of the insured to the medical insurance information system in a timely and accurate manner;

3. After seeing a doctor, the insured shall keep the prescription, outpatient receipt (outpatient invoice), detailed list and other relevant documents, and submit them to the unit or social security office for reimbursement of medical expenses in time;

4. After receiving the outpatient (emergency) consultation expenses of the insured declared by the unit and social security, the county medical insurance center will compare the relevant documents with the electronic information uploaded during the consultation, and reimburse the medical expenses that meet the requirements of basic medical insurance;

5. After reimbursement, retirees directly transfer money to the insured's personal passbook through the bank, and the reimbursement bill is sent to the individual through the post office, and the on-the-job personnel are paid by the unit.

Medical insurance reimbursement conditions:

1. Confirm the insured status: before seeking medical treatment, you need to confirm that you have participated in local medical insurance, which can be confirmed by means of social security card and medical insurance certificate;

2. Medical category: Medical insurance generally only reimburses therapeutic medical behaviors, such as outpatient service, hospitalization, surgery and examination. Some cosmetic medical behaviors, such as dental beauty and plastic surgery, are usually not covered by medical insurance reimbursement;

3. Medical expenses: Medical insurance will only reimburse medical expenses that meet the requirements, such as medical expenses, medicine expenses, examination expenses, operation expenses, etc. Personal expenses, medical insurance will not be reimbursed;

4. Hospital qualification: Medical insurance will only reimburse the medical expenses of legally operated medical institutions, such as public hospitals and qualified private hospitals. Medical insurance will not be reimbursed for illegal medical institutions or clinics.

To sum up, there may be differences in medical insurance policies in different regions. Please consult the local social security agency or relevant medical insurance service agencies for specific reimbursement procedures and requirements.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

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.