┃Source: National Medical Insurance Bureau, Xinhua Viewpoint
According to the National Medical Insurance Bureau, as of the end of November, 97.6% of the coordinated areas have achieved direct inter-provincial settlement of ordinary outpatient expenses, and the number of designated medical institutions has been connected to 43,200; the number of designated retail pharmacies is 80,200.
It is reported that from January to November, the national outpatient expenses were directly settled across provinces by 8.1051 million person-times, involving medical expenses of 2.035 billion yuan, the fund paid 1.118 billion yuan, and the proportion of fund payment was 54.9%.
The national unified online filing service continues to be optimized. By the end of November, all provinces and the Xinjiang Production and Construction Corps had launched a unified national online filing service. 99.6% of the coordinated areas rely on the national off-site medical record-filing mini-program and the national medical insurance service platform APP to achieve cross-provincial medical treatment filing. From January to November, 585,800 people were successfully filed through the national unified online filing channel.
So, how to check whether the insured place is open? Which designated medical institutions can directly settle? How to file for off-site medical treatment for direct settlement of outpatient expenses across provinces...
1. How can I check whether the place of insurance is open?
Insured persons can inquire through 3 channels.
——The official account of the National Medical Insurance Bureau. Click "My Medical Insurance" - "Public Inquiry" - "Open the Coordinating Area for Direct Inter-Provincial Settlement of General Outpatient Expenses" in the navigation bar below the official account, select the province that needs to be queried, and then search for the co-ordination area that has been opened.
——National Medical Insurance Service Platform website. Click "Pilot Inquiry on Direct Settlement of Inter-provincial Outpatient Expenses" in the lower left corner of the web page to enter the section, and then click "Pilot Area Situation Inquiry" in the lower left corner to inquire.
——National medical insurance service platform App. Click "Business Handling" - "Off-site Medical Treatment" - "Outpatient Inquiry" - "Pilot Area Outpatient Opening Area Inquiry" to inquire.
2. Which designated medical institutions can directly settle accounts?
——The official account of the National Medical Insurance Bureau. Click "My Medical Insurance" - "Public Inquiry" - "Designated Medical Institutions That Open Cross-Provincial Direct Settlement of General Outpatient Expenses" in the navigation bar below the public account, select the province or coordinated area that needs to be queried, and click "Query", and the search results will be the designated medical institutions that have opened the cross-provincial direct settlement of outpatient expenses.
——National Medical Insurance Service Platform website. Click on the "Inter-provincial Outpatient Fee Direct Settlement Pilot Inquiry" in the lower left corner of the web page to enter the section, click "Off-site Network Designated Medical Institution Inquiry" in the lower left corner, which can be searched according to the categories of "Networked Medical Institutions" and "Networked Retail Pharmacies".
——National medical insurance service platform App. Click "Business Handling" - "Off-site Medical Treatment" - "Outpatient Inquiry" - "Off-site NetworkEd Designated Medical Institution Inquiry", you can select the corresponding province, co-ordination area or enter the name of a designated medical institution in the search bar to query.
3. Does the direct settlement of outpatient expenses across provinces require off-site medical recordal?
In this regard, the National Medical Insurance Bureau clarified:
Insured persons who have applied for the direct settlement and filing of basic medical insurance for medical treatment and hospitalization expenses in different provinces and other provinces shall simultaneously open the inter-provincial direct settlement service for ordinary outpatient expenses without additional filing;
The direct settlement policy of outpatient fees across provinces is different in different places, and other personnel with general outpatient medical needs shall apply for medical treatment in different places in accordance with the management requirements of the insured place for medical treatment in different places;
Through the official account of the National Medical Insurance Bureau, the insured person can inquire whether the insured place needs to be filed, and can also consult the medical insurance agency of the insured place for specific requirements.