Pilot direct settlement of ordinary outpatient (emergency) clinics for medical treatment in Beijing, Tianjin and Hebei

Four Grade-A general hospitals including Peking Union Medical College Hospital were included in the first batch

  News from our newspaper (Reporter Liu Huan) Yesterday, the Beijing Municipal Medical Insurance Bureau issued the "Notice on Announcement of the List of the First Batch of Designated Medical Institutions in Beijing to Open the Direct Settlement Service for General Outpatient (Emergency) Clinics in Beijing, Tianjin and Hebei Provinces". Four Class-A general hospitals, including Peking Union Medical College Hospital and China-Japan Friendship Hospital, were included in the first batch of designated medical institutions for direct settlement of ordinary outpatient (emergency) clinics in different places in Beijing, Tianjin and Hebei.

  In accordance with the requirements of the "Notice on the Direct Settlement of General Outpatient (Emergency) Medical Expenses for Beijing-Tianjin-Hebei Cross-province Medical Treatment in Beijing-Tianjin-Hebei Basic Medical Insurance", it has been reviewed by the municipal and district medical insurance agencies and passed the information system business acceptance , Beijing Union Medical College Hospital (No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing), Beijing Chaoyang Hospital (No. 8, Workers Stadium South Road, Chaoyang District, Beijing, No. 5 Jingyuan Road, Shijingshan District), and the 307th Hospital of the People’s Liberation Army (Beijing) No. 8 Dongdajie, Fengtai District), China-Japan Friendship Hospital (Yahuayuan East Street, Chaoyang District, Beijing, Shuangquanbao No. 2, Chaoyang District, Beijing) 4 designated medical institutions have met the standards for opening related services, and these 4 designated medical institutions are determined Medical institutions are included in the first batch of designated medical institutions for direct settlement of ordinary outpatient (emergency) clinics in remote areas of Beijing, Tianjin and Hebei.

  According to reports, the opening date of Peking Union Medical College Hospital is January 1, 2020. The opening date of the three designated medical institutions of Beijing Chaoyang Hospital, the 307th Hospital of the People's Liberation Army, and the China-Japan Friendship Hospital is July 30, 2020.

  The notice requires that medical insurance agencies in all districts need to strengthen the work guidance, supervision and management of pilot designated medical institutions, and rationally arrange personnel for careful review and timely payment of relevant medical expenses. All pilot designated medical institutions shall consciously abide by and strictly implement the relevant regulations of medical insurance, actively strengthen management, regulate medical behavior, and provide the same services and management for the insured persons in different places as the insured persons in this city.

  According to the "Notice on the Direct Settlement of General Outpatient (Emergency) Medical Expenses for Beijing-Tianjin-Hebei Cross-province Medical Treatment in Beijing Basic Medical Insurance", insured persons in different places shall directly settle and seek medical treatment in outpatient clinics in this city, and they must follow the relevant policies of the place of insurance. It is stipulated that the registration procedures for direct settlement and filing at outpatient clinics should be handled in advance or without going through the outpatient service. Participants can directly settle outpatient medical expenses directly settled by designated medical institutions in this city, and implement the payment scope and relevant regulations (basic medical insurance drug catalog, medical service facilities and diagnosis and treatment project scope) stipulated by Beijing basic medical insurance; The insurance fund minimum payment standard, payment ratio, maximum payment limit, etc. shall implement the policy of the place of insurance.

  In addition, insured persons from other places directly settle and seek medical treatment in the outpatient clinics of this city and execute related procedures of designated medical institutions in this city. When medical registration and settlement, you need to actively show your social security card and seek medical treatment under your real name; when direct settlement in outpatient clinics, you only need to settle the expenses that should be borne by the individual with the designated medical institution. The expenses are paid by the medical insurance fund and belong to the jurisdiction of the designated medical institution The medical insurance agency will settle the settlement with the designated medical institution after review; the medical expenses that are fully settled by the insured persons in different places shall be reimbursed manually in the place of enrollment according to the original prescribed procedures.