China News Service, August 6th. The website of the National Medical Security Administration recently announced the public service information on the direct settlement of cross-provincial medical treatment in different provinces (issue 49).
It shows that in June 2022, about half of the country's overall planning areas (208 in total) will start five outpatient chronic diseases, including hypertension, diabetes, malignant tumor outpatient radiotherapy and chemotherapy, uremic dialysis, and anti-rejection treatment after organ transplantation. Cross-provincial direct settlement of related treatment expenses will be piloted to further promote cross-provincial direct settlement of outpatient expenses.
1. Cross-provincial direct settlement of hospitalization expenses operates stably
As of the end of June 2022, 58,600 designated medical institutions have been connected to 58,600 designated medical institutions for inter-provincial direct settlement of hospitalization expenses across the country; from January to June, 2.4659 million person-times of hospitalization expenses across the country were directly settled across provinces, involving 55.416 billion yuan in medical expenses and 32.311 billion yuan in fund payments , the fund payment ratio is 58.3%.
In June, 475,800 national hospitalization expenses were directly settled across provinces, involving 10.399 billion yuan of medical expenses and 6.180 billion yuan of fund payments, up 20.6%, 21.6%, and 22.5% month-on-month respectively; the fund payment ratio was 59.4%; the average daily direct settlement 15,859 person-times, the average medical expenses per time is 21,900 yuan, and the average fund pays 13,000 yuan per time.
2. Cross-provincial direct settlement of outpatient expenses has grown steadily
By the end of June 2022, 65,900 designated medical institutions and 165,300 designated retail pharmacies had been directly settled across provinces nationwide; from January to June, 11,128,500 people had been directly settled across provinces, involving 2.692 billion medical expenses. Yuan, the fund paid 1.616 billion yuan, and the fund payment ratio was 60.0%.
In June, 2,452,500 people were directly settled across provinces for outpatient expenses across the country, involving 572 million yuan in medical expenses and 349 million yuan in fund payments, up 25.1%, 25.5%, and 23.7% month-on-month respectively; the fund payment ratio was 61.1%; the average daily direct settlement 81,751 person-times, the average medical expenses per time is 233.25 yuan, and the average fund payment per time is 142.39 yuan.
3. The APP of the National Medical Insurance Service Platform has added query functions such as the notification of chronic and special diseases in outpatient clinics across provinces
In order to facilitate the insured to directly settle the treatment costs related to 5 kinds of outpatient chronic and special diseases across provinces, the APP of the national medical insurance service platform has added query functions such as the notification letter of inter-provincial outpatient chronic and special diseases.
The insured can download the APP of the National Medical Insurance Service Platform, click on the "remote location filing" column, and add the "door slow special notification letter" and "door slow special qualification" query function in the sub-column of "more inquiries about medical treatment in other places".
The insured can learn about their existing qualifications for outpatient chronic and special disease identification and the policies and procedures for the cross-provincial direct settlement of outpatient chronic and special disease-related expenses in the insured place.
At present, the cross-provincial direct settlement of the five types of outpatient chronic and special disease-related treatment fees is still in the pilot stage. If there are problems during the settlement process, the insured can consult the service hotline of the insured place.
(Zhongxin Finance)
Picture from the website of the National Medical Security Administration