Medical insurance direct settlement of 6.69 million visits to doctors across provinces
Medical insurance is more convenient and reimbursement is more labor-saving
Mr. Zhang from Xingtang County, Shijiazhuang City, Hebei Province, suffered from internal carotid artery thrombosis and went to Beijing Tiantan Hospital for medical treatment. When he was discharged from the hospital, he enjoyed direct settlement of medical treatment in different places across provinces without paying any advance funds.
What surprised Mr. Zhang most was that the three protection benefits he enjoyed were basic medical insurance, critical illness insurance, and medical assistance, which were settled in a “one-stop” manner at the time of discharge. There was no need to go through the reimbursement procedures separately, and the reimbursement ratio reached 91.4%.
In recent years, like Mr. Zhang, more and more patients enjoy the convenience of direct settlement of medical treatment in different places.
As of the end of June, a total of 6.69 million person-times have enjoyed the convenience of direct settlement of medical treatment in different places across provinces.
Among them, inter-provincial hospitalization expenses were directly settled 5.35 million person-times; Beijing-Tianjin-Hebei, Yangtze River Delta, and the five provinces of Southwest China were directly settled across provinces in three pilot outpatient clinics, and 1.34 million person-times were directly settled.
-Let the information run, the masses don't have to run errands to make money.
In the past, people needed to pay in advance for medical treatment in different provinces, and they had to return to the insured place with receipts and materials when reimbursing.
In December 2016, the national cross-provincial direct settlement system for medical treatment and hospitalization expenses in different places was put into use, and the information was networked across the country.
The items seen in the visiting hospital are different from the reimbursement items in the insured area. How to reimburse?
Don't worry, the settlement platform has already designed policies and implemented the "list of medical places and treatment standards for insured places" to facilitate medical staff to conduct diagnosis and treatment according to their habits.
Patients who seek medical treatment in different places do not have to pay medical expenses first when they are hospitalized, because the implementation of "prepayment first, liquidation later" reduces the pressure on medical institutions to advance funds.
At present, all provinces, all coordinated areas, all types of insured persons, major types of out-of-office, and key medical institutions are included in the direct settlement system for cross-provincial and remote medical treatment, and more and more people enjoy the convenience of direct settlement.
As of the end of June 2020, the number of designated medical institutions across the country for medical treatment in different regions has reached 31,673, of which 28,755 are designated medical institutions at the second level and below, and they have maintained a continuous growth trend.
——Simplify the procedures, and you can do the filing with one click.
Recently, Hegang City, Heilongjiang Province opened an online remote medical record service.
Aunt Wang, a long-term insured person in Hegang City, Beijing, quickly downloaded the "National Medical Insurance Service Platform" app and filed it. The procedures are simple and direct settlement after discharge.
At present, there are four types of people who can enjoy direct settlement of medical treatment in different places across provinces, relocation of retirees, long-term residents in different places, long-term workers in different places, and people who refer to different places.
Before going to a doctor in a different place, these people need to "file, select a point, and go to the doctor with a card."
Nowadays, the filing procedures are becoming more and more simplified, and insured persons in many areas can make filings through APP and WeChat.
In December last year, the National Medical Insurance Administration launched a small program for national medical records in other places.
Currently, 77 coordinated areas in 18 provinces including Shanxi, Inner Mongolia, and Liaoning have opened online filing services as pilot areas.
With the construction of a unified national medical security information system, it will be realized before the end of 2020 that eligible cross-provincial patients seeking medical care in all designated hospitals will be able to see a doctor with a card and settle instantly.
——Include outpatient clinics, and medical insurance becomes better.
Aunt Wang from Jiaxing City, Zhejiang Province, went to Shanghai to live with her daughter and went to Ruijin Hospital to dispense medicine every month.
After the pilot direct settlement of outpatient clinics in the Yangtze River Delta region was opened, she filed for the record. When visiting the clinic, she swipes her medical insurance card to register and pay, and the medical insurance payment fee is automatically deducted.
Aunt Wang said happily: "It's so convenient. Medical insurance is equally easy to use everywhere."
The Yangtze River Delta region was the first to open an inter-provincial direct settlement service for outpatient expenses.
Last year, 41 cities in three provinces and one city in the Yangtze River Delta (Jiangsu, Zhejiang, Anhui, and Shanghai) realized the "One Card" for medical insurance.
At present, the number of designated medical institutions has reached 6,486, with a total of 1.33 million settlements, total medical expenses of 320 million yuan, and medical insurance funds of 190 million yuan.
Xia Kejia, director of the Shanghai Municipal Medical Insurance Bureau, said: “In order to facilitate the people in the Yangtze River Delta to go to outpatient clinics in different places, the three provinces and one city have overcome many policy and technical difficulties, improved the accessibility of high-quality medical resources by urban and rural residents, and enhanced the happiness of the people. A sense of gain."
This year's "Government Work Report" proposed to carry out a pilot project for direct settlement of outpatient expenses across provinces.
Huang Huabo, director of the Fund Supervision Department of the National Medical Insurance Administration, said that compared with the direct settlement of hospitalization expenses, the settlement of outpatient treatment is not small.
Nevertheless, in order to facilitate more medical insured residents in different places, following the Yangtze River Delta region, the five southwestern provinces and the Beijing-Tianjin-Hebei region have successively launched pilot projects for direct settlement of outpatient expenses across provinces, so that insured residents in need can enjoy direct settlement as soon as possible convenient.
Our reporter Li Hongmei