Shenzhen has 87 national platforms for designated medical institutions to go online, which can achieve direct settlement of hospitalization expenses for cross-provincial treatment in accordance with the conditions for filing! Recently, the reporter learned from the Shenzhen Social Insurance Fund Administration that Shenzhen has basically realized the direct settlement of medical expenses in different places in the country. The city's third- and second-level medical insurance designated hospitals and some first-class fixed-point hospitals with large medical treatments are connected to the country for medical treatment. Direct billing platform.
Cross-provincial medical treatment to achieve full coverage of medical institutions above the second level
"In the future, my parents will see a doctor in Shenzhen Hospital. They don't need cash advances and then run back to their hometown for reimbursement." Mr. Ma excitedly told reporters that his parents had retired from Xi'an and lived in Shenzhen. The hospitalization of medical treatment last month realized the direct settlement of medical insurance expenses. There are not many examples like Mr. Ma’s parents. Shenzhen is a city, and there are many old people moving around. For those who are insured in different places, if they want to be hospitalized in Shenzhen, they will face the problem of reimbursement across the area. For Shenzhen policy holders, there are times when they go to other places to seek medical treatment. occur. In the past, insured persons who had been treated in different places had to pay medical expenses, copy medical records, and then go back to the local social security agencies for reimbursement, which was very inconvenient.
Since April 2017, the Municipal Social Security Bureau has carried out the construction of a direct settlement platform for hospitalization expenses for hospitalization in different provinces. As of April 30 this year, there have been 87 designated medical institutions in the city to access the national platform, including 34 three-level fixed-point hospitals, 34 second-level fixed-point hospitals, and 19 first-class fixed-point hospitals. Fully realize the city's second-level fixed-point medical institutions and the first-level fixed-point medical institutions with large medical treatments in different places to access the national platform, and realize the direct settlement of the hospitalization expenses for cross-provincial medical treatment in accordance with the filing conditions. The city's insured persons were hospitalized in the city for medical treatment and settled through the national platform for a total of 549 person-times. The medical insurance bookkeeping fee was 11.337 million yuan. The medical institutions in our city provide 11,287 direct settlement services and medical expenses of 222 million yuan for the medical insurance hospitalization of provincial insured persons through the national platform.
It is necessary to be specially reminded that the scope of the population that can be directly settled by the medical institutions that access the national platform in Shenzhen requires the insured to confirm with the social security institution of the participating area, and also to apply for a social security card that meets the requirements of cross-provincial medical treatment. And in the insured place to handle the corresponding cross-provincial medical procedures for filing. At present, the city's talent park window, social security bureau branches and management stations have set up 31 administrative windows, which can accept applications for medical records in different provinces and handle the filing procedures.
596 hospitals in different places in the province can be enrolled in social security card hospitalization
As for the settlement of medical treatment in different places in Guangdong Province, as of April 30, a total of 684 medical institutions in the provincial platform have achieved online settlement. Among them, there are 88 designated medical institutions in the city, including 34 tertiary hospitals and 34 secondary schools. Hospital and 20 first-class hospitals. This means that the insured persons in Guangdong Province can be enrolled in the 88 hospitals in Shenzhen, and the insured persons in other cities in Guangdong Province can choose the medical institutions in Shenzhen according to the specific requirements of the social security agencies in the participating areas. The medical expenses for hospitalization in different places directly settled the hospital.
In order to speed up the mutual recognition of the medical institutions in different places on the Guangdong Province, on December 28, 2016, Shenzhen City clearly included all on-site medical institutions in the field to be managed by designated medical institutions outside the city. As of April 30, Shenzhen City has mutually recognized the remote medical institutions on the Guangdong Provincial Platform, and has achieved direct settlement with the hospitalization expenses of 596 designated medical institutions in the province. This means that Shenzhen insured persons can be enrolled in social insurance cards in 596 hospitals in different places in Guangdong Province, realizing the real-time accounting of the expenses. The insured person does not need to pay the cash and return to the Municipal Social Security Bureau for reimbursement.
As of April 30, the medical institutions of our city have provided 30,176 person-times of direct medical settlement services to the insured persons in 20 provinces and cities through the provincial platform, and the medical expenses reached 547 million yuan. The city's insured person settled 53,901 person-times through the provincial new platform, and the medical expenses reached 1.282 billion yuan. (Shenzhen Special Zone Daily)
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