[Tide Yangtze River Delta] "All-in-one card" for medical treatment in the Yangtze River Delta: You can use the Shanghai medical insurance card to see a doctor in Nanjing

  Chinanews client, Nanjing, October 16th (Zuo Yukun) People are unwell outside of the country, so do you have to pay for the outpatient service before seeing a doctor?

After seeing a doctor, the reimbursement rate is slow when going home.

  Direct settlement for medical treatment in different places has always been a hot issue of concern to the general public.

On the 15th, the "Tide Yangtze River Delta · When Co-construction is in Progress" thematic network communication event interview team came to Jiangsu Provincial People's Hospital to learn about the first implementation of direct settlement in the Yangtze River Delta region as a major livelihood project in remote outpatient clinics.

Citizens are seeking medical treatment in other places.

Photo by Zuo Yukun

Shanghai Medical Insurance Nanjing swipes a card, no longer reimburses for medical treatment in different places

  Ms. Sun, who lives in Shanghai, had an abnormal index in her physical examination last month and plans to review it.

Ms. Sun's work unit is Shanghai Baosteel, and the medical treatment is naturally Shanghai's medical insurance.

But on the afternoon of the 15th, Ms. Sun visited the outpatient clinic at Jiangsu Provincial People's Hospital in Nanjing and settled all expenses directly by swiping her card.

  What Ms. Sun enjoys is the result of direct settlement of the outpatient expenses of Jiangsu Provincial People's Hospital.

  "In order to further expand the coverage of direct settlement of medical treatment in different places across provinces, the National Medical Insurance Bureau is actively promoting the pilot work of direct settlement of outpatient expenses in Beijing, Tianjin, Hebei, Changsha, Triangles and three areas in the five southwestern provinces have been piloted and have achieved initial results." On September 30, Huang Huabo, Director of the Fund Supervision Department of the National Medical Security Administration, held a government affairs service "Cross-provincial connection" State Council policy briefing on September 30 Said at the meeting.

  In the integration of medical treatment in different places in the Yangtze River Delta, the Nanjing medical insurance department took the lead in implementing the "one-single system" settlement for outpatient clinics in different places, and the scope of insurance types and types of outpatient clinics were further expanded.

At the same time, we will advance the way of in-person filing and optimize the procedures and links.

The People's Hospital of Jiangsu Province has opened a special "Special Window in the Yangtze River Delta".

Photo by Zuo Yukun

  "Before, if you wanted to see an outpatient clinic in a different place, you had to pay for it yourself, and then take the invoice and related cases back to the medical insurance office in Shanghai for reimbursement. However, the reimbursement has to wait in line for several weeks before the money can be returned to the account, which is long and troublesome. "Ms. Sun said.

  So in July 2019, when I heard that I could swipe the card in another place, Ms. Sun quickly tried it out: "It feels very convenient. As long as you file in advance, you can save the reimbursement step and save more than half of the time. Originally, we are all Ordinary employees don’t have many holidays, and the government has really done something to benefit the people."

  Up to now, outpatient expenses in the Yangtze River Delta region have cross-provincial direct settlement of cumulative visits, total medical expenses, and medical insurance fund payments accounted for 98% of the three pilot areas.

Among them, Nanjing accounts for a quarter of the Yangtze River Delta.

New progress has been made in inter-provincial and remote settlement between hospital and outpatient fees

  Speaking of medical treatment in different places, I believe everyone is no stranger to direct settlement of hospitalization expenses for medical treatment in different places across provinces.

  "In 2016, we launched the direct settlement of medical and hospitalization expenses across provinces and other places, and decisive progress was made." On September 30, Huang Huabo, Director of the Fund Supervision Department of the National Medical Security Administration, held a government service "Cross-provincial General Administration" policy of the State Council at the State Council Information Office. Said at the regular briefing.

  According to data, as of September 28, 2020, the number of people registered on the national platform was 7.11 million, and the number of networked designated medical institutions was 35,739, of which 32,742 were designated medical institutions at the second level and below.

Since its launch in January 2017, a total of 6.19 million direct settlements for cross-provincial medical treatment have been realized, the total medical expenses were 149.70 billion yuan, and the medical insurance fund paid 88.36 billion yuan, with a payment ratio of 59.0%.

  Lu Zhensheng of the Pukou Branch of the Jiangsu Provincial People’s Hospital told Chinanews.com that it was the first to carry out the direct settlement of hospitalization expenses across provinces because the requirements for hospitalization in various places are similar, and it is easier to implement; but the regulations on outpatient expenses are The difference is large, and the implementation is naturally more difficult.

The Jiangsu Provincial People's Hospital can see the promotion of medical treatment in different places.

Photo by Zuo Yukun

  In order to implement this policy well, in 2020, as the largest public hospital in Jiangsu Province, Jiangsu Provincial People’s Hospital will upgrade its medical insurance office to a medical insurance department, enhance the hospital’s medical insurance functions, and coordinate with multiple departments in terms of equipment, venues, and informatization. Ensure the smooth progress of medical insurance "inter-provincial settlement".

  As of the end of September 2020, Jiangsu Provincial People's Hospital has ranked first in Jiangsu Province and the forefront of the country in the number of off-site medical insurance services.

More than 16,000 cases have been directly settled in outpatient clinics across provinces and other places.

Among them, from April 2019 to present, there are 14,551 cases in Shanghai; from October 2019 to present, 1,215 cases in Zhejiang Province; and from July 2020 to present, 1,119 cases in Anhui Province.

A social security card used by citizens when seeking medical treatment in other places.

Photo by Zuo Yukun

  "Medical insurance is a political project and a people’s livelihood project." Zhao Jun, president of Jiangsu Provincial People’s Hospital, said that the realization of the policy allows Jiangsu Provincial People’s Hospital to better provide high-quality, efficient, safe, warm, Appropriate and convenient medical services.

  "We believe that the innovative exploration of the direct settlement of medical insurance in different places for outpatient clinics in the Yangtze River Delta will also provide important experience for the country to promote the settlement of medical insurance policies in different places, which has great reference significance." Zhao Jun said.