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Qinhuangdao Qinglong social security center
Social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
Guiding opinions on further improving the settlement of medical expenses for medical treatment in different places in basic medical insurance
Two, improve the municipal co-ordination, to achieve direct settlement of medical treatment in the city.
In order to fully realize the direct settlement of medical expenses within the city, we will promote and improve the municipal overall planning of basic medical insurance. First of all, it is necessary to unify the basic medical insurance fund budget and financing treatment policy, medical management and information system integration, and gradually improve the convenience of basic medical insurance services. In areas where the urban and rural basic medical insurance system is integrated, it is necessary to simultaneously promote the medical insurance for urban and rural residents to achieve municipal overall planning.
Areas that have implemented the overall urban planning should further improve the quality of the overall urban planning. To adopt the mode of unified revenue and expenditure, it is necessary to clearly define the responsibilities of social insurance agencies at the county and county levels (hereinafter referred to as agencies) and implement the responsibility of hierarchical management; If the adjustment fund model is adopted, it is necessary to standardize the collection and adjustment management of adjustment funds, and gradually realize the unification of system and policy, fund management, medical settlement, handling services and information systems. Where conditions permit, it is necessary to accelerate the overall planning at the provincial level.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.
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