202 1 Beijing-Tianjin-Hebei medical treatment process in different places

First, check the designated medical institutions in different places to ensure that they can be directly reimbursed in the hospital. Log on to the national social insurance public service platform and inquire about the "designated medical institutions in different places" that can be directly settled;

Second, the employer where the insured person is located (the useless unit insured person is handled by the street social security office) holds the social security card of the insured person (hereinafter referred to as the social security card) to the medical insurance agency to which the insured person belongs to handle the "hospitalization card activation" procedure of the social security card. Insured persons with social security cards who go through hospitalization settlement procedures in Beijing do not need to go through the "hospitalization card activation" procedure.

Third, put on record. The insured unit holds the Registration Form for Direct Settlement Filing in duplicate and the social security card of the insured person to submit the application for direct settlement filing of the insured person for medical treatment in different places to the social security agency. Interpretation: To be on the safe side, it is recommended that the insured or agent bring their own identity documents, the social security card of the insured and two registration forms for filing in different places.

Four, the direct settlement of hospitalization expenses in different places is completed, and it will take effect the next day.

Scope and standard:

1, direct settlement of hospitalization medical expenses, implementation of the prescribed scope of medical treatment payment and related regulations (basic medical insurance drug list, medical service facilities scope and diagnosis and treatment items);

2, the medical insurance fund Qifubiaozhun, payment ratio, maximum payment limit and settlement period. Implement Beijing medical insurance policy;

3. For the expenses directly settled in medical insurance coverage, calculate the daily average cumulative treatment.

Precautions:

1. Insured personnel shall directly settle accounts in different places and be hospitalized in designated medical institutions for the record, and go through relevant procedures for medical treatment. When handling admission registration, discharge settlement and other procedures, you need to take the initiative to show your social security card and seek medical treatment under your real name;

2. If the insured person needs to settle the expenses in full for some reason, the expenses paid by the medical insurance fund shall be reimbursed manually according to the original prescribed process;

3. If the insured chooses "Hebei Yanda Hospital", he needs to fill in the registration form of real-time settlement of inter-provincial medical expenses in Hebei Yanda Hospital.

1. The relevant person in charge of the Municipal Social Security Center said that if the insured person goes out temporarily and is hospitalized in an emergency in other places, it shall be implemented with reference to the relevant regulations on the management of medical treatment in different places for the insured person of the basic medical insurance for urban employees in Tianjin. Insured persons living in other places with Tianjin household registration need medical treatment, and they can choose one local first-,second-and third-class hospitals and specialized hospitals, register and put on record at the place where the insurance payment is made, and the social security agency at the place where the insurance payment is made will fill in the Registration Form for Resettlement Personnel of Tianjin Urban and Rural Residents' Basic Medical Insurance for the record. Pay the medical expenses that meet the requirements in the filing hospital.

Two, to the insurance agencies for the record, I need to hold my social security card and ID card (e-card has been opened as a whole, just show the medical insurance e-card), entrust others to hold the ID card, medical ID card and social security card. Referral and transfer were limited to medical treatment in different places at that time. Re-application for filing is required for follow-up and transfer. If the medical expenses are settled in cash, the medical insurance reimbursement shall be implemented according to the policy of the insured place.

Third, insured persons who have gone through the long-term registration procedures for medical treatment in different places may not change their medical treatment places again within six months. If it is really necessary to go to a place other than the place of filing for medical treatment, the insured shall be filed according to the types of people referred from other places, and the corresponding treatment policies shall be implemented.