Must medical records be required for reimbursement in medical in

1. To apply for medical insurance, the case report and my medical insurance card should go to the medical insurance window of the administrative service center for approval and cancellation.

2. Hospitalization with medical insurance blueprint is directly reimbursed, and no case is needed.

3. Passing by abdominal black, of course, there are invoices that match the date of the medical record. If not, how can you prove that you are the expense of this hospitalization?

4.

The of medical record is the information needed for medical insurance reimbursement. The of medical record is provided by the hospital or doctor for patients to query, and seal

the right subject of ing medical records

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4. Full time personnel of public security and judicial organs needed for handling cases. In addition, other people have no right to the patient's medical record

when medical institutions accept the application for ing or plicating medical records, the Department responsible for the quality control of medical services or the department or ward responsible for the custody of outpatient (emergency) medical records will send the medical records to the designated place within the specified time limit and or plicate them in the presence of the applicant

extended data

the total coverage rate of urban and rural residents in China remains above 95%. Although it is close to the goal of "everyone enjoys medical insurance", the "difficulty of reimbursement for medical treatment in other places" still affects migrant workers, the elderly who live with their children in other places, and the seriously ill patients who seek medical treatment in other places. At this year's two sessions, it has become a hot topic for the representatives and members to realize the real-time settlement and reimbursement of medical insurance in different places as soon as possible

However, the overall planning level of the above-mentioned medical insurance, especially the residents' medical insurance and the new rural cooperative medical fund, is low, and the overall planning level of most provinces and localities stays at the prefecture level, even at the district and county level, resulting in medical insurance patients going out of the county, The reimbursement of medical expenses is limited. In recent years, with the migration of population, the contradiction has become increasingly prominent

5. There are many proceres for medical insurance reimbursement in different places. All the hospital certificates have to be taken. There is no other way.

6. Under normal circumstances, social security institutions will not go to the hospital to verify the cases one by one
when ing a case, the staff of the hospital will objectively the case according to the archived data, and then affix the official seal of the hospital to prove that the is consistent with the original. Social security can be reimbursed according to the local policy, which will not be met in the hospital.

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1. Materials required for outpatient reimbursement: original medical information such as outpatient medical records, inspection and test results report; Original ID card; Original medical diagnosis certificate; The original receipt of general outpatient and emergency charges, the detailed list of outpatient charges or the original prescription (the prescription is pasted on the back of the receipt by date)

2. Materials required for reimbursement of childbearing expenses: one original and one of childbearing service certificate; A of the baby's birth certificate; One of medical diagnosis certificate; All the original receipts and prescriptions (Chinese and Western medicine expenses) are sorted out according to the date. The medical expenses of 4 yuan can be reimbursed

3. Materials required for reimbursement of work-related injury: the application form for identification of work-related injury is in quadruplicate, and the is invalid One original and one of diagnosis certificate and outpatient (inpatient) cases or occupational disease diagnosis certificate; One original and one of the labor contract; A of ID card of the injured person

extended data

social insurance reimbursement refers to the behavior that social insurance compensates the medical expenses, childbearing expenses and work-related injury treatment expenses of employees and residents in proportion

social security card has a wide range of functions. Cardholders can not only make real-time settlement of medical insurance personal accounts with their cards, but also handle endowment insurance affairs; Apply for job registration and unemployment registration; Apply for unemployment insurance benefits; Apply for employment training; Apply for labor ability appraisal and enjoy instrial injury insurance benefits; Handle labor and social security affairs on the Internet

Network - Social Security reimbursement

Network - social security card of the people's Republic of China

8. 1、 Medical expenses documents sorting. 1. The outpatient and emergency department of the insured unit can be reimbursed. In service employees can only be reimbursed if they are more than 1800 (if they can't make up enough within one year, they will enter supplementary medical treatment). Retirees can only be reimbursed if they are more than 1300. 2. The reimbursement time is from the 1st to the 20th of each month, and the expenses of the current year will be declared before the 20th of the next year. 3. When declaring, a detailed statement of settlement shall be sealed. B two copies of approval form with official seal C outpatient department, the original of emergency receipt (if there is a drug charge, the prescription of some hospitals should be printed below the original of the receipt) d receipt details, the details of various expenses e when seeing a doctor, except for the hospitals written on the blueprint and other hospitals that do not need the blueprint, the remaining hospitals can only see the emergency department. F in case of emergency observation and hospitalization observation, the reimbursement ring the period before hospitalization is the same as that ring hospitalization. 4. Expenses incurred in other places, can not return to Beijing for treatment, can be reimbursed, but must provide travel proof. Retirees' expenses incurred in other places can only be reimbursed by visiting relatives, and other expenses will not be handled. 2、 First of all, go to the third floor (Haidian District Social Security Center) to import personnel information. 2. Manual reimbursement is divided into upload and non upload. Upload is a sign in the upper right corner of the invoice. There's nothing to upload. 3. Pay special attention to the cost of diagnosis and treatment (composed of two parts, in which the registration part is not used). A. outpatient non upload operation: 1. Medical common input - & gt; General outpatient expenses entry - & gt; Input number - & gt; Query, to a document a document record, record number is the number under the bar code, that is the document number, no number is not recorded-& gt; New - & gt; Unit information - & gt; Save (if you want to record the next one, just add a new one) - & gt; Generate approval - & gt; Confirm - & gt; Audit form (in plicate) with official seal. The diagnosis and treatment fee can be entered in the treatment fee, one by one, or together (summary). Finally, after all the information is entered, an approval form is generated. 2. If you can't tell the difference between self payment and non fee, you can enter them all. Social security has been audited. 3. The approval form should be placed one by one. 4. Then there is the data offer - & gt; General outpatient service - & gt; Query - & gt; Offer - & gt; Save as - & gt; File name (cannot modify file name and format) save - & gt; Print the detailed summary (in plicate) and finally print one. 5. In a word, the reimbursement materials are: receipt, approval form, summary form and USB flash disk. B for uploaded bills: 1. Uploaded expense management - & gt; Uploaded - & gt; Upload the bill entry information (the same as before) - & gt; Input one by one - & gt; Save - & gt; To generate an approval, the documents are set on the approval document (one person makes one set). The data submission is the same as that of the above non upload documents - generate the file name (the file name cannot be changed). PS: when making an offer, the documents are submitted together (for example, 10 persons are summarized together). If one person has a non upload document and an upload document, it is calculated separately, not by person, but by type. 2. After the social security is recovered, the receipt will be issued. C reimbursement error change: non upload: comprehensive query - & gt; Offer history query (general clinic) - & gt; Enter company name and offer date - & gt; Query - & gt; Click the information you want to change (offer transaction on the left) - & gt; Click offer back - & gt; The input approval window will appear, and then modify it. Comprehensive query - & gt; Approval history query - & gt; Select the information to change - & gt; Back - & gt; The initial general outpatient inquiry PS: if there is no offer and the approval form has been printed out, it can be directly changed from the approval form. Upload: upload historical data - & gt; Back - & gt; Approval form - & gt; Back - & gt; Do it again.

9.

After discharge, you can go to the hospital for reimbursement. Generally, the first half of the year will be reimbursed in the second half of the year, and the second half of the previous year will be reimbursed in the first half of the year

according to the basic requirements of basic medical insurance payment in China, the insured must go to the designated medical institutions of basic medical insurance to pay for their own medical expenses, which generally meets the following conditions:

(1) the insured must go to the designated medical institutions of basic medical insurance to buy medicine, Or purchase drugs from designated retail drugstores determined by social insurance institutions with prescriptions issued by doctors of designated hospitals

(2) the medical expenses incurred by the insured in the process of seeing a doctor must meet the scope and payment standard of the drug catalogue, diagnosis and treatment items, medical service facilities standard of the basic medical insurance, and can be paid by the basic medical insurance fund according to the regulations

(3) among the medical expenses of the insured who meet the payment scope of the basic medical insurance, the expenses above the starting standard of the social medical co-ordination fund and below the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion

extended data:

medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. Through the payment of employers and indivials, the medical insurance fund is established. After the medical expenses of the insured are incurred, the medical insurance institution will give them certain economic compensation

The role of medical insurance: first, it is concive to improving labor proctivity and promoting the development of proction

Medical insurance is the inevitable result of social progress and proction development. Conversely, the establishment and improvement of medical insurance system will further promote social progress and proction development. On the one hand, medical insurance relieves workers' worries and makes them work at ease, which can improve labor proctivity and promote the development of proction; On the other hand, it also ensures the physical and mental health of workers and the normal reproction of labor force

Second, adjust the income gap to reflect social equity

medical insurance is an important means of income redistribution for the government to adjust the income gap by collecting medical insurance fees and paying medical insurance service fees

Third, it is an important guarantee for maintaining social stability

Medical insurance is an important social mechanism to adjust social relations and social contradictions

Fourthly, it is an important means to promote social civilization and progress

the social system of medical insurance and social mutual assistance reflects the new social relationship of "one party has difficulties, all parties support" by sharing the risk of disease expenses among the insured, which is concive to promoting social civilization and progress

Fifth, it is an important guarantee to promote the reform of economic system, especially the reform of state-owned enterprises

10.

The proceres are as follows:

1. On admission: Patients with medical insurance should go through the social security registration proceres with their ID cards, and then go to the ward for hospitalization

2. When discharged: the doctor arranged the patient to be discharged, and went to the charge office to handle the discharge settlement proceres with the admission registration form and ID card

at present, the reimbursement process has been simplified. Patients do not need to go to the social security center for reimbursement, and can settle accounts directly in the hospital

the so-called hospitalization reimbursement of medical insurance is not that you pay cash in advance and then pay with bills, but that when you are hospitalized in a designated hospital of medical insurance, you issue a medical insurance card to let the unified medical insurance settlement system read the information of the insured and handle the hospitalization number. When you are discharged from the hospital, the medical insurance system will not receive the "part of the reimbursement" - the overall payment part

extended data

reimbursement scope of medical insurance:

1. The reimbursement of medical insurance card is limited to the medical expenses above hospitalization caused by diseases and some accidents in designated hospitals

the reimbursement formula is as follows: (total expenses - threshold expenses - self expense - overspending expenses) * (75 + age * 0.2)%. Under normal circumstances, the actual reimbursement proportion varies from 20% to 60%

self funded drugs are not reimbursable, class B drugs are reimbursable by 80%, bed fee is limited, and some inspection fee and diagnosis and treatment fee according to the regulations are not reimbursable

2. The reimbursement amount of medical insurance card is 4 times of the average salary of local social workers (accumulated value within one year)

3. The money in the medical insurance card can be used to buy medicine in the designated drugstore and pay for outpatient and emergency expenses, but it does not belong to the reimbursement category, because the money in the medical insurance card is the money in the medical insurance indivial account

4. Reimbursement of serious illness insurance

after a serious illness occurs to the insured, the part of indivial's own responsibility that occurs in the designated medical institutions of the city's medical insurance and conforms to the provisions of the city's medical insurance will be included in the payment scope of residents' serious illness insurance, and 50% will be reimbursed by the serious illness insurance fund

that is, the reimbursement amount = the self financing part × 50%