Clearly, Lianyungang primary medical outpatient reimbursement 75%!
The reporter learned from the medical insurance department of Lianyungang City that according to the spirit of relevant national and provincial documents, in accordance with the overall plan of "Class B tube" and the requirements of "protecting health and preventing serious illness", Lianyungang City quickly optimized and implemented relevant medical security policies, and implemented "Class B tube" from the date of new coronavirus infection, and implemented it first until March 31, 2023.
The hospitalization expenses are all included in the comprehensive security.
Make clear the payment policy of hospitalization medical insurance in COVID-19. Novel coronavirus infected patients in all medical institutions, in line with the health department to develop novel coronavirus infection treatment program of hospitalization medical expenses, in the basic medical insurance, serious illness insurance, medical assistance and other payment in accordance with the provisions, the personal burden of part of the financial subsidies.
Outpatient reimbursement of primary medical institutions is 75%
To clarify the reimbursement ratio of special outpatient support in COVID-19. Cooperate to promote the implementation of graded diagnosis and treatment, guide patients to seek medical treatment at the grassroots level, and ensure stable and orderly medical services. For outpatient and emergency expenses of patients with novel coronavirus infection and suspected symptoms in designated medical institutions (secondary and below medical institutions), there is no deductible line and reimbursement limit for medical insurance fund payment, and the proportion of basic medical insurance fund payment is 75%.
It is understood that this policy will increase the support of medical insurance to primary medical institutions (secondary and below medical institutions) in rural areas and urban communities, so as to guide patients to primary medical treatment and promote the implementation of graded diagnosis and treatment. If the outpatient and emergency expenses of novel coronavirus infection treatment for insured patients in other medical institutions occur, they shall be implemented according to the existing outpatient security policy.
Non-designated medical institutions are temporarily included in the management of medical insurance settlement agreement according to regulations.
Non-designated medical institutions are temporarily included in the management of medical insurance settlement agreements. Open a green channel for non-designated medical institutions with the ability to accept infected patients in Covid-19, and sign the Temporary Special Agreement on Medical Insurance Expense Settlement of Medical Institutions with the requirements of medical insurance agreement management with non-designated medical institutions in accordance with the requirements of medical insurance agreement management, and incorporate it into the management of medical insurance settlement agreement according to regulations.
The temporary special agreement is valid from the date of signing to March 31st; After the expiration, if it is voluntarily included in the fixed-point management of basic medical insurance, it is necessary to re-submit an application for agreement management to the local medical insurance department and accept the assessment according to the regulations.
The first consultation of "internet plus" medical service is included in the medical insurance payment.
In view of novel coronavirus’s open Internet first-visit service, medical insurance mobile payment and settlement services are provided for patients who have symptoms related to novel coronavirus infection and meet the Guidelines for Home Treatment of Covid-19 Infected Persons according to regulations. The municipal medical insurance department provides support according to the principle of online and offline consistency, and the price policy and reimbursement standard of Internet first-visit medical services are consistent with offline. The follow-up service for infection-related symptoms in novel coronavirus is still implemented according to the existing reimbursement policy for Internet follow-up.
Do a good job in the settlement of expenses for patients with novel coronavirus infection in different places
The hospitalization, outpatient and emergency expenses of infected patients in novel coronavirus in networked hospitals with conditions in different places are uniformly included in the networked direct settlement. Temporarily do not have the conditions, the insured patients can hold the relevant outpatient bills to the insured medical insurance agencies to apply for manual reimbursement, unified implementation of the insured novel coronavirus infection and suspected symptoms of patients with outpatient and emergency special security policy. The medical expenses incurred by the hospitalization expenses of infected patients in different places in novel coronavirus will continue to implement the national inter-provincial liquidation policy, and the personal burden will be settled by the financial funds of the medical treatment places.