What documents do you need to bring to the medical insurance cen

1. 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.

2.

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%

3. It depends on the specific regulations of the medical insurance center where you are insured. Generally, it is necessary to provide invoice, diagnosis certificate, detailed expense list, of medical insurance card, of ID card, of my bank passbook, traffic police department's certificate of responsibility for traffic accident, unit certificate, hospitalized cases, etc.

4.

Social medical insurance reimbursement is after discharge or transfer
settlement proceres for inpatients and outpatients with special diseases:
designated medical institutions shall report the expense settlement sheet, inpatient settlement sheet and relevant information of discharged patients in the previous month to the medical insurance agency before the 10th day of each month, which will be used as the basis for monthly budget and year-end final accounts after being reviewed by the medical insurance agency
medical insurance agencies pre allocate the overall expenses of hospitalization and outpatient treatment of special diseases in the previous month
the insured with special diseases should go to a designated medical institution designated by the labor and social security department for medical treatment and purchase, and the medical expenses incurred should be directly recorded and settled immediately
emergency settlement procere: the medical expenses incurred by the insured who are hospitalized in non designated medical institutions and other medical institutions in the city e to emergency rescue shall be paid in advance by the indivial or unit. After the end of emergency rescue, the reimbursement proceres shall be handled by the medical insurance agency according to the regulations with the hospital emergency medical records, examination, laboratory report, invoice and detailed medical charge list
settlement procere for off-site resettlers:
the unit where the off-site resettlers are located shall designate 1-2 designated medical institutions for them and report them to the medical insurance agency for record
the medical expenses incurred by the staff in different places who are ill in the designated medical institutions of their residence shall be paid by themselves or their units in advance. After the treatment, their units shall go to the social medical insurance agency for settlement with the medical certificates and medical records of the insured, valid expense bills, plicate prescriptions, hospitalization expenses list, etc. on the specified date
referral settlement:
if the insured is transferred to other medical institutions for diagnosis and treatment e to the limited conditions of designated medical institutions or special diseases, they need to fill in the referral approval form. The reason for referral should be put forward by the doctor in charge, the director of the Department should put forward the opinion of referral, the medical insurance office of the medical institution should review, the president in charge should sign and report to the Municipal Medical Insurance Center for approval
in principle, referral should be made from within the city to outside the city, from within the province to outside the province. It is stipulated that referral within the city should be concted among designated medical institutions. Referral outside the city shall be proposed by designated medical institutions at or above the third level of the city
for the medical expenses incurred by the insured after referral, the indivial or unit shall pay in cash first. After the medical treatment, the insured or his agent shall go to the medical insurance agency for reimbursement of the hospitalization expenses within the scope of the overall planning fund with the referral approval form, medical record certificate, prescription and valid documents

How to buy insurance, which is better, hand in hand to teach you to avoid these "pits" of insurance

5. ID card, medical insurance card, medical record and diagnosis certificate when necessary

6.

Materials to be provided for medical insurance reimbursement:

1. Transfer certificate issued by Municipal Hospital

2. The transfer certificate issued by the hospital should be submitted to the local social security department (Medical Insurance Department) for examination and approval

3

4. Original cost list

5. One valid of inpatient medical record (valid with hospital seal)

6. One of ID card

reimbursement proceres for medical treatment in other places:

1. The patient's ID card, two one inch color photos and new rural cooperative medical certificate should be transferred to the county cooperative medical management office for filing

2. Bring the patient's ID card, new rural cooperative medical certificate and referral filing proceres to the referral hospital for medical treatment, and handle the new rural cooperative medical hospitalization proceres

3. After discharge, the patient should submit his / her ID card (or household register), new rural cooperative medical certificate, of medical record, hospitalization settlement sheet (some in the form of invoice), list of hospitalization expenses and referral filing proceres to the cooperative management office for reimbursement

extended data:

the following are not the reimbursement scope of rural cooperative medical insurance:

1. Self medical treatment (no designated hospital or no referral form), self purchased drugs, drugs that cannot be reimbursed according to public medical regulations and medical expenses that do not conform to the total planning

2. Outpatient treatment expenses, visiting expenses, hospitalization expenses, board expenses, accompanying expenses, nutrition expenses, blood transfusion expenses (except those with family blood storage, which shall be reimbursed according to relevant regulations), cooling and heating expenses, rescue expenses, special care expenses and other expenses

3. Medical expenses of traffic accident, fight, suicide, alcoholism, instrial accident and medical accident

The cost of orthopedics, plastic surgery, dental inlay, artificial limb, organ transplantation, name calling operation, consultation, etc

5

many farmers buy some commercial medical insurance after they buy the new rural cooperative medical system. If they buy the commercial medical insurance, you have to first claim the expenses of the new rural cooperative medical system, and then you can claim the remaining expenses from the insurance company

7.

The original of the original charge data sheet, the original of the expense detail sheet, the original of the outpatient medical record, the original of the diagnosis, the emergency hospitalization certificate, the original of the social security card, the original of the ID card (the agent's ID card should also be provided), the original of the bank account (passbook or bank card is OK), Original unit certificate

if the applicant wants to apply for the reimbursement of the second level hospitalization expenses of medical insurance, he needs to meet the following conditions:

1. He has gone through the insurance proceres, paid the medical insurance expenses in full on time, and the insurance time is on the 1st of the next month

2

3. When the insured went to the medical institutions that had been registered, they had incurred hospitalization expenses, which had been paid in advance, and had the corresponding medical expense documents and hospitalization materials

< H2 > extended information:

reimbursement process:

first, the applicant needs to go through the reimbursement application proceres, and then submit the relevant application materials required for reimbursement. The place of submission of materials is the medical insurance Department of the social security branch of the Social Security Fund Management Bureau

after receiving the reimbursement application from the applicant, the acceptance Department of the administration will check the application materials provided by the applicant within 5 days from the date of receiving the materials, and decide the final acceptance result

if the application materials are wrong or incomplete, the acceptance department will inform the applicant and inform him to prepare the required materials at one time within 5 days, and correct the wrong contents in the materials

and the applicant should complete the material correction within 5 days from the date of receiving the notification of material correction. If the time limit is exceeded, no correction will be made and the application will be withdrawn

if the materials have been supplemented and corrected within the time limit, the application can be reapplied within the validity period of medical insurance reimbursement

8.

The following information is required for reimbursement:

1. Original ID card or social security card

2. The original diagnosis certificate issued by the doctors of designated medical institutions

3. Outpatient medical records, examination, test results report and other original medical information

4. The original receipt of outpatient charges of medical institutions unified by finance and tax

5. The detailed list of outpatient expenses printed by the hospital computer or the original payer's prescription issued by the doctor

6. Designated drugstores: the original of unified invoice and computer printed list for tax commodity sales,

7. If it is handled on behalf of a person, the original ID card of the agent shall be provided

materials required for instrial injury reimbursement:

Application Form for instrial injury identification in quadruplicate, 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:

hospitalization:

1. Reimbursement scope: the hospitalization expenses of the insured in the designated hospital or specialized hospital of medical insurance, traditional Chinese medicine hospital and class a hospital selected by indivials

2. Hospitalization starting line: in a natural year, the first hospitalization starting standard is 1300 yuan, and then 650 yuan each time

3. Reimbursement proportion: 90% in the first level hospital, 87% in the second level hospital, and 85% in the third level hospital, with a total reimbursement of 300000 yuan

4. Handling process: please use the "Beijing Medical Insurance Manual" when seeing a doctor. If the unit pays in full, the indivial only needs to pay part of the hospitalization prepayment to go through the hospitalization proceres. The medical expenses incurred should meet the scope of medical insurance. When leaving the hospital, the hospital and the indivial should settle the part of their own expenses, and the reimbursement amount of the overall fund should be settled by the hospital and the district medical insurance center

9. Medical insurance reimbursement without any documents, medical insurance is the abbreviation of medical insurance, outpatient can not use medical insurance. Medical insurance can only be used in inpatients and special outpatient departments. Now the local accounts are used in the local hospital, and the medical insurance is settled directly in the hospital. The local medical insurance bureau does not accept the settlement from the medical insurance bureau. Only in other places, for example, if you are hospitalized in another place, you can bring the hospitalization invoice, case and disease certificate to your account location for settlement. When you are hospitalized in a local hospital, just show your medical insurance card when you are hospitalized. In this way, the system will automatically remove the medical insurance.