Chongqing medical insurance reimbursement process

Legal analysis: reimbursement process: after the patient is admitted to the hospital, the medical insurance patient can go through the social security registration formalities in the hospital with his ID card, medical insurance card and other documents; When patients are discharged from the hospital to settle medical expenses, they do not need to go to the social security center for reimbursement when they are waiting for the discharge settlement formalities at the inpatient charging office with the admission registration form and ID card. After being audited by relevant departments, the applicant can receive the Social Medical Insurance Medical Expense Reimbursement Form for reimbursement. For reimbursement of medical expenses, if the medical expenses incurred by the insured in the agreed medical institutions meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, they can only be paid from the basic medical insurance fund in accordance with state regulations. The first-aid expenses and medical service expenses of the insured shall be reimbursed according to the local actual situation and the formulation of specific management measures.

Legal basis: Article 8 of the Detailed Rules for the Implementation of the Social Insurance Law of People's Republic of China (PRC), if the medical expenses incurred by the insured in the agreed medical institutions meet the standards of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities, they shall be paid from the basic medical insurance fund in accordance with state regulations. If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution; The scope of drugs that must be used for rescue can be appropriately relaxed. The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.