How to open the medical insurance referral certificate in different places?

Find the attending doctor of the insured hospital to issue a diagnosis certificate and put forward the reasons for referral. Then go to the hospital charge office and give the diagnosis certificate and referral opinion to the staff for seal. After receiving the opinions, the insured can apply for referral registration with the medical insurance card, ID card and referral certificate to the Social Security Bureau (or the Medical Insurance Agency). After completing the registration, he will receive a receipt (this is the referral certificate). Then go through the formalities of medical treatment in different places at the Social Security Bureau and choose designated medical institutions. When visiting a doctor in a different place, give the referral certificate to the hospital, and you can directly use medical insurance to settle the account when you leave the hospital.

The lack of referral certificate has a great impact on medical insurance reimbursement in different places, and the proportion of medical insurance reimbursement will be greatly reduced, and even some areas can not be reimbursed at all. This depends on local policies. In order to make the reimbursement more powerful, Bian Xiao still suggests that you issue a referral certificate. The condition requires it. Generally, only when the medical level of the local hospital can't be treated can you apply for referral. The specific judgment is given by the hospital, and the referral procedure is slightly troublesome.

Generally, you can carry your ID card and medical insurance card. In addition, you should keep the examination and diagnosis results of the hospital at the first time to facilitate the subsequent referral treatment. Fill in the application form. The name of the application form in different places is similar, and it is generally an application form for the transfer of employees participating in the basic medical insurance for urban employees in xx City. Just fill in the form. Hospital audit. Generally, it is necessary to designate the chief physician of the relevant department of the tertiary hospital to make a diagnosis, give a referral suggestion and sign it, and then the hospital medical insurance office will review and seal it.

First, the audit of social security institutions. After the hospital audit, it is necessary to take the materials audited by the hospital to the local medical insurance unit for audit and filing, so as to facilitate the subsequent expense reimbursement. Referral treatment. After starting the referral certificate, you can go to the referral hospital for medical treatment as soon as possible, and bring back the treatment materials for reimbursement after the treatment. According to the regulations of the health department, patients need to be referred to the attending doctor first, and the attending doctor will report to the department director. After the director confirms that the patient really needs to be transferred to a higher-level medical institution for treatment, he will issue a transfer certificate, which will be sealed by the medical department of the hospital.

Second, the process of reimbursement for medical treatment in different places: before hospitalization or within 3 days after hospitalization, call the consultation number of the new rural cooperative medical system in your hometown to register for hospitalization; After discharge, the residence certificate must be issued by the neighborhood office or neighborhood Committee of the place of residence. If you work outside, you need a work certificate issued by your work unit; After discharge, submit a copy of medical records, a summary list, hospitalization bills and discharge certificates, and then submit them to the participating places for reimbursement with the patient's ID card, cooperative medical certificate, residence or work certificate; If you go directly to a hospital outside the province for chemotherapy from the participating place, you must go through the referral and transfer procedures before you can go to a foreign hospital for treatment. The proportion of reimbursement outside the province is the lowest, and the general deductible is around 2000, accounting for 45% of the reasonable expenses. If you spend less, it is difficult to reimburse. The lower the hospital level, the higher the reimbursement ratio.