A medical insurance card, swipe through the three provinces and cities of the Yangtze River Delta

Zhejiang News Client reporter Zhang Mengyue Zhouyi Sharing Alliance Ding Lan Weirong Station Shouying

Inquiry from outpatient clinics, settlement of cards, and prescribing medicine ... On August 16, the Dingqiao Hospital of Hangzhou Traditional Chinese Medicine Hospital, the citizen Wang Ling completed the consultation once. Unlike other patients, the medical insurance card in her hand comes from Nanjing, Jiangsu. In the past two years, the mother who accompanied the insured place in Nanjing to seek medical treatment across the province was Wang Ling's "home -often."

Although it was a cross -provincial medical treatment, Wang Ling and his mother were "lightly put on the battle" -the neither had a small bag with medicine, nor needed to collect the hospital invoice receipt for reimbursement. "These are all past types. After the long -term triangle cross -provincial medical clinic expenses are settled directly, we don't need to go back and forth in different places to reimburse medical expenses."

Medical insurance cannot be reimbursed directly by swiping cards across provinces. It used to be a big pain point for ordinary people to see a doctor. Since 2017, insured personnel have gradually achieved direct card settlement for hospitalization expenses across provinces. However, for the elderly with high incidence of chronic diseases and frequent flow of flowing, the demand for outpatient consultations is greater. In 2021, only Hangzhou insured personnel settled in the long -term provinces in the Yangtze River Delta, with a settlement of 149,100 people, an increase of 120%year -on -year.

Recalling the dilemma when the outpatient settlement did not "get through", Wang Ling calendar: "The former clinics could not be reimbursed directly. Mother's mother came to Hangzhou to prepare a lot of medicines. First pay for medical expenses to return to the place of insurance, the process is cumbersome, and the waiting period is very long. "

In 2018, the state took the lead in conducting pilots in the Yangtze River Delta region, and in August 2020, it realized the direct settlement of medical clinics for medical clinics in the whole region of the Soviet Union, Zhejiang, Anhui, and Shanghai provinces. "Focus on solving the three major pain points of the insured persons, high funding pressure, and reimbursement." The relevant person in charge of the Hangzhou Medical Insurance Bureau said.

From January to June this year, the insured persons in Hangzhou were directly settled in other cities in other cities in the Yangtze River Delta, and the cost of direct settlement for medical treatment was 75,900 yuan, and the settlement amount was 18.5579 million yuan. During the same period, 157,200 insurers in other cities in the Yangtze River Delta were settled in Hangzhou's inter -provincial settlement outpatient costs, with settlement costs of 29.8572 million yuan.

The expenses of the long triangle clinic are settled directly in the province. Recently, Hangzhou citizen Zhong Cheng, a business trip in Shanghai, had a sudden oral disease and temporarily visited Shanghai. Although it was a temporary period of medical treatment during the temporary period, his medical expenses could be settled directly as long as the individual first took care of it. "Very convenient, just like seeing a doctor at home."

According to the relevant person in charge of the Hangzhou Medical Insurance Bureau, this measure was launched on January 1 this year, mainly for the convenience of insured persons who need to seek medical treatment across provinces during the temporary period of temporary travel, tourism, and relatives. "In the future, with the continuous upgrading of the smart medical insurance platform system, when some people participating in the insured are temporarily going out, some expenses of the self -care for the emergency medical treatment will also be completely resolved, and the real -time emergency medical treatment is directly settled."

At present, Hangzhou is actively exploring the direct settlement of outpatient slow special diseases across provinces, which is about to achieve five outpatient diseases such as hypertension, diabetes, malignant tumor outpatient chemotherapy, uremia dialysis, and organ transplantation. Direct settlement and relevant testing of participation and medical place have been completed.

As of the end of June this year, there were 6,949 designated medical institutions in the Yangtze River Delta region that can directly settle outpatient expenses in Hangzhou's insured persons; in our province's designated medical institutions can provide a total of 3,626 directly settled in other cities with insured personnel in the long triangle, of which 1237 Hangzhou City has achieved full coverage of all districts and counties (cities) in the city.

"Next, we will further expand the coverage of medical institutions for medical institutions in Hangzhou different places, optimize and improve the medical information system of different places, focus on improving the stability of credit card settlement, improve the direct settlement rate, and promote the facilitation level of medical insurance services among cities in the urban circle." The relevant person in charge of the Hangzhou Medical Insurance Bureau said.

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