good news!There are new deployments in direct settlement of medical insurance across provinces

Author:Xi'an released Time:2022.07.26

The two departments further promote the direct settlement of cross -province medical treatment

The National Medical Insurance Bureau and the Ministry of Finance issued the "Notice on Further Doing a Basic Medical Insurance Cross -Provincial Different Settlement Work" on the 26th, deepening the direct settlement reform of cross -provincial medical treatment directly, and cracking the problem of difficulties and difficulties in the medical treatment of different places.

Promoting the direct settlement of cross -provincial medical treatment costs is an important reform measure to improve the medical insurance system and solve the outstanding concerns of the people.

The notice clearly clearly settled the "Fourteenth Five -Year Plan" target task of direct settlement of inter -provincial and different places. Before the end of 2025, the direct settlement system system and management service system of cross -provincial medical treatment systems are more sound. Different places have a significant improvement in medical settlement capacity, and the direct settlement rate of hospitalization expenses across provinces increases to more than 70%.

The notice uniformly uniformly set up direct settlement such as hospitalization, ordinary outpatient and outpatient slow special diseases, and clearly implemented the "medical land catalog and place to participate in the insurance" fund payment policy in principle during cross -provincial direct settlement; Fixed -point and code cards to seek medical treatment services for different places; "prepaid, then liquidation" for medical management requirements for medical treatment funds.

The notice further regulates the filing policy of different places, including the scope of the personnel of the medical treatment records to the inter -provincial emergency personnel and non -emergency consultation personnel; uniformly filing validity period, the insured during the validity period can be visited many times and enjoy the direct settlement service at the medical place multiple times and enjoy the direct settlement service ; Support participants to enjoy treatment in both directions in the record place and the place of insurance.

In addition, the scope of direct settlement services for fixed -point medical institutions is notified, and the expenses of emergency rescue costs, out -of -hospital check -up treatment costs, and non -third -party trauma costs that meet the regulations of medical ground management are included in the direct settlement scope of cross -provincial medical treatment. Insured participants are allowed to apply for medical treatment before discharged and settled, and enjoy cross -provincial direct settlement services.

In terms of coordinated business, notifying the cross -regional collaborative process of the agencies, the establishment of a mechanism for collaborative treatment of medical sites and participating places, and improving the efficiency of collaborative disposal of regional issues.

The notice requires that the medical insurance departments in various places should adjust relevant policies and measures in a timely manner to ensure that they will be connected with national policies by the end of December 2022. Relevant policies will be officially implemented from January 1, 2023.

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