How to reimburse medical insurance for outpatient service in different places

The reimbursement methods for social security cards in different places are as follows:

1, personnel seeking medical treatment in different places shall go through the registration procedures for medical treatment in different places first;

2, after the medical treatment, with the relevant bills to the insured medical insurance agencies for reimbursement procedures;

3. If the medical insurance network settlement is realized between the insured place and the medical treatment place, the medical expenses can be directly settled by swiping the medical insurance card at the medical treatment place.

Precautions for medical insurance in different places are as follows:

1, different cities have different medical insurance policies and regulations, so you should pay attention before seeking medical treatment.

2. Medical personnel in different places need to consult the local medical insurance management department to see if there are any preferential policies.

3. It usually takes about one month to apply for approval in different places, so medical staff in different places should apply in advance, otherwise there is nowhere to reimburse the medical expenses during the rest period.

The scope of medical insurance reimbursement is as follows:

1. Self-seeking medical treatment (no designated hospital for medical treatment or no referral form), self-purchasing drugs, drugs that cannot be reimbursed according to the regulations of free medical care and medical expenses that do not meet the requirements of family planning.

2. Outpatient treatment fee, visiting fee, hospitalization fee, food fee, escort fee, nutrition fee, blood transfusion fee (except for family blood donors, reimbursed according to relevant regulations), cooling and heating fee, ambulance fee, special nursing fee, etc.

3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents.

4. Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc.

5, within the scope of reimbursement, beyond the limit.

Legal basis:

Social insurance law

Article 25

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 28

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.