Tianjin 2017 dental health insurance reimbursement scope, this is the point where we need to know the benefits for us, so that the benefits are maximized!!!!

Social health insurance reimbursement is reimbursed after discharge or transfer.

Settlement procedures for hospitalization and outpatient treatment of special diseases:

Specified medical institutions before the 10th day of each month, will be discharged from the previous month's patient's fee statement, hospitalization statement and related information to the health insurance agency, the health insurance agency audit, as a basis for the monthly advance allocation and the end of the year final accounts;

Medical insurance agency monthly advance allocation of the previous month's hospitalization and outpatient treatment of special diseases

Participants who are recognized as suffering from special diseases should go to one of the designated medical institutions designated by the labor security department for medical treatment and purchase of medicines, and the medical expenses incurred will be recorded directly in the accounts and settled instantly.

Emergency Settlement Procedures: If a participant is hospitalized in a non-designated medical institution in the city or in a medical institution in a different place due to an emergency, the medical expenses incurred shall be paid by the individual or the unit in advance, and after the emergency is over, the participant shall go through the reimbursement procedures with the hospital's emergency medical record, examination and laboratory report form, invoice, and a detailed list of medical charges, etc., in accordance with the provisions of the medical insurance agency.

Settlement procedures for relocated staff:

Relocated staff shall be assigned 1-2 designated medical institutions in their place of residence by their units and report to the medical insurance agency for record;

Medical expenses incurred by relocated staff who are sick in designated medical institutions in their place of residence shall be advanced by the staff member himself/herself or by his/her unit, and the medical expenses incurred shall be paid by the staff member himself/herself or by his/her unit in advance, and then the medical expenses shall be paid by the staff member himself/herself by his/her unit with the medical fee list of the insured person.

The medical expenses incurred by a staff member residing in a foreign country who is ill at a designated medical institution shall be paid in advance by the staff member or his/her unit, and after the treatment is completed, the medical expenses shall be settled by his/her unit with the staff member's medical certificate and medical records, valid expense bills, duplicate prescriptions, and list of hospitalization expenses, etc., on the specified date at the social medical insurance agency.

Referral and transfer settlement:

If the insured person is referred to other medical institutions for diagnosis and treatment due to the limitations of the designated medical institutions or due to specialized diseases, he/she has to fill in the approval form for referral and transfer. By the attending physician to put forward the reasons for referral and transfer, the department director to put forward the referral and transfer opinions, the medical insurance office of the medical institution audit, the signature of the dean in charge, reported to the Municipal Medical Insurance Center for approval before transfer;

The referral and transfer of hospitals, in principle, first in the city and then out of the city, the first in the province and then out of the province. The transfer within the city is required to be carried out among the designated medical institutions. Out-of-town referrals and transfers must be made by the city's designated medical institutions above the third level;

The medical expenses incurred by the participant after the referral and transfer to the hospital shall be advanced in cash by the individual or the unit, and after the completion of the medical treatment, the participant or his/her representative shall reimburse the hospitalization expenses that belong to the scope of payment of the integrated fund to the medical insurance agency with the approval form for the referral and transfer to the hospital, the medical record certificate, the prescriptions and the valid documents.