What is the medical insurance reimbursement process in Chengdu?

Legal analysis of reimbursement process of medical insurance for urban residents

(1) Reporting settlement data

Check the hospitalization invoice and affix the detailed list of hospital expenses with the medical insurance card, and affix the hospitalization record and the complete Medical Insurance Referral Form for Urban Workers with the copy of the voluntary letter for drugs and special medical treatment items outside the catalogue.

(2) Settlement

If the insured person is hospitalized in a different place and the procedures are complete, he can directly go to the social security center for settlement and reimbursement with the receipt and his ID card after 5 working days. It should be noted that reimbursement will be suspended from 28th to the end of each month and resumed from 1 the following month. If medical insurance is directly reimbursed and settled in different places, these procedures need to be completed first: first register for the record, choose a designated medical institution, and then hold a card for medical treatment. Reimbursement requires a copy of the original ID card and the original rural cooperative medical card. As well as the admission certificate, discharge certificate, charge documents during hospitalization, total charge documents at discharge, and copies of medical records of diagnosis certificate.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) shall be paid by the industrial injury insurance fund (2) shall be borne by a third party (3) shall be borne by public health (4) overseas medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.