For medical treatment in different places, the latest notice of the Hubei Provincial Medical Insurance Bureau!

A few days ago, the Hubei Provincial Medical Security Bureau issued the "Notice on Further Improve the Convenience of Direct Settlement of Different Places" (hereinafter referred to as "Notice"), from broadening the registration channels for medical treatment in different places, regulating the management of medical treatment for different places, clarifying the policy settlement policies of different places, expanding the expansion Five aspects of medical institutions covering medical institutions in different places, and accelerating the promotion of information system transformation have deployed and optimized relevant policies, further improved the convenience of direct settlement of medical treatment in different places, and ensured that insured persons in our province enjoy more efficient medical settlement services for different places.

Basic medical insurance insured persons in different places include: remote resettlement retirees filing, long -term residents filing in different places, filing of resident staff in different places, filing of remote referring personnel, and other temporary medical staff filing. Provincial, city, county, township (street), village (community) level five.

The "Notice" proposes to further expand the channel for medical treatment for different places. Participants can apply for medical treatment for different places in the township (street) government service centers and village (community) convenience service centers in the county areas of the insurance place. Duan Xiaojou, Ehui Office APP, Hubei Provincial Political Service Network and other online channels apply to apply for medical treatment procedures for different places.

The "Notice" regulates the management of medical treatment in different places. Receive personnel, long -term residents in different places, long -term residents, and residents in different places have been filed for long -term validity; referral personnel and other temporary medical staff will have a validity period of 6 months. Allows to reissue the direct settlement service of different places after medical treatment, and the qualified insured personnel arranged for the referral for medical treatment reasonably.

In terms of medical settlement in different places, the "Notice" clarifies the reimbursement policy for medical staff for different places. When the medical direct settlement is settled in different places, in principle, the scope of payment and relevant regulations stipulated in the medical place is implemented. Relevant policies such as payment ratio, maximum payment limit, outpatient slow disease disease scope. In principle, the payment ratio of the referral personnel decreases by no more than 10 percentage points compared with the local medical treatment. In principle, the other temporary medical staff paying ratio decreases by no more than 20 percentage points than the local medical treatment.

At the same time, the insured participants enjoy medical insurance treatment in both directions and the bidirectional of the insured place, and support the outpatient clinic for slow and special costs. Insured personnel who need to return to the insurance place for medical treatment within the validity period of the medical treatment in a different place. There is no need to revoke the filing, and the medical insurance settlement service can be enjoyed at the place of insurance. The medical insurance treatment is consistent with the local medical treatment.

In addition, the "Notice" proposes to expand the coverage of medical institutions for medical treatment at different places. The cities (states) level 2 and above medical institutions and counties (cities, districts) people's hospitals, traditional Chinese medicine hospitals, and maternal and child health care hospitals are all included in the scope of designated medical institutions for medical treatment in different places; all the designated medical institutions of slow special diseases in each overall planning area are included in different places. Settlement scope.

In order to further settle the direct settlement service for medical treatment, the "Notice" requires that the Hubei Provincial Medical Security Information Platform and Hubei Provincial Government Service Integrated Platform should be further strengthened to upgrade and transform the information system, improve the functions of the medical system of different places, and standardize the processing process. Improve the quality and efficiency of the problem.

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