Pan Pearl 3 Provinces, 6 Cities, Medical Insurance Card Brush Time Is Not Yet Clear.

Guangzhou medical insurance card is expected to pass in the Pan Pearl River Delta region. Yesterday morning, 3 provinces, including Hunan, Hainan, Yunnan and other 6 provinces, including Fuzhou, Nanchang, Changsha, Guangzhou, Nanning, Chengdu and other medical insurance agency representatives signed the "framework agreement for social medical insurance cooperation in different provinces and cities in the Pan Pearl River Delta region" at the Guangzhou site (hereinafter referred to as the "framework agreement"). However, the time for exchanging medical insurance cards is not yet clear.

It is reported that the move is a pilot test of the nationwide medical treatment in different places, and will produce a demonstration effect for the realization of the larger scale medical insurance card mutual brush.

1 million 500 thousand Guangzhou Insured person Direct benefit

The problem of "heavy burden of personal medical expenses, difficulty in reimbursement between the two places" has long troubled the insured participants in Guangzhou. To this end, the Guangzhou Municipal Health Insurance Bureau and the Pan Pearl River Delta region provinces and provincial capitals jointly planned the immediate settlement project for medical insurance recipients. According to the introduction, this cooperation will be based on the Pan Pearl River Delta region's 9 provinces (cities) as a pilot project, and build an immediate settlement platform for medical insurance recipients in different regions. Provinces and cities convergence We will gradually build a real-time settlement network covering the Pan Pearl River Delta region and all parts of the country.

He Jiming, deputy director of the Guangzhou Municipal Medical Insurance Bureau, said that every year, 5%-10% medical insurance recipients in Guangzhou had to go to other places for medical treatment, and the medical insurance fund paid 100 million yuan for off-site reimbursement each year. "In fact, 7 million of the insured people in Guangzhou will be an indirect beneficiary." He said that after the implementation of the project, 1 million 500 thousand of the insured persons in Guangzhou will be directly benefited. More importantly, the implementation of the project will benefit the insured population in other areas of the Pan Pearl River Delta region and other areas participating in cooperation in the future, especially those of the 3 million provinces who work in Guangzhou.

A large number of people who move between provinces and cities are also the project. Beneficiary Such as retired elderly who follow their children's different lives, resettlement personnel in different places, and cross regional employment personnel.

Medical treatment in different places still enjoys local treatment.

Is the insured person in Guangzhou seeing a doctor in Hunan? Is the accounting reimbursement ratio different from that in Guangzhou? He Jiming said that in the process of immediate settlement, the parties concerned will follow the mode of "localization of medical care management (treatment places), treatment standard localization (insurance places), settlement mode informatization and networking", that is, the medical treatment process, registration, audit and settlement operation of all participants in different places, and will be carried out according to the relevant provisions of the medical treatment; and the basic medical insurance treatment and payment standard shall be implemented according to the provisions of the insured area.

He said that instant settlement greatly facilitating the access of insured persons to other places. When they seek medical treatment in cooperation, they only pay part of their personal burden, while the accounting part is immediately settled by local hospitals. The cost of settlement by different medical institutions can be declared to the local medical insurance institutions, and the local medical insurance institutions should pay for them from the working capital. The final liquidation is carried out by the medical insurance agencies of the partners regularly.

"There is no difference between the procedures to be processed in different places, and those in Guangzhou. He Jiming laughed and said that only when the settlement was settled, the insured would feel that the burden was "sharp", because the parts that could be reimbursed according to the regulations were all accounted for.

Giving priority to hospitalization expenses settlement

　
Medical insurance policy in different places, Guangzhou medical insurance treatment can also be achieved in different places? The reporter understands that the establishment of a remote medical settlement cooperation system will give priority to the immediate settlement of the hospitalization expenses of all parties involved in resettlement and the hospitalization expenses of the referral insured. From then on, we will further expand the field of cooperation and gradually realize the immediate settlement of fees for common doors (urgent), outpatient clinics and so on.

He Jiming said that after the signing of the agreement, the cooperative medical insurance institutions will work closely together to build a grid mode. "Pushing forward very fast, our conditions are ripe." But when the medical insurance card is being brushed, the medical insurance department has not yet set out a specific timetable.

Will the sharing of medical resources in large areas increase the pressure of medical resources in Guangzhou? He Jiming believes that the situation of difficult cases and diseases in the top three hospitals in large cities will not be aggravated or reduced due to the immediate settlement of different places.

Insured people visit different places

1, apply for medical treatment elsewhere.

2, holding certificates for medical treatment in medical institutions where they are seeking medical treatment.

3, medical institutions long-distance inquiries insured people in different places for effective information

4, insured persons pay a certain proportion of deposit for admission procedures.

5. When going through the discharge formalities, calculate the basic medical expenses according to the three catalogues.

6, the insured medical insurance agency remotely settle accounts according to the basic medical expenses and return to the settlement data.

7, the insured person can pay the personal expenses after completion of discharge procedures.