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Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!

Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!

Recently, the Ministry of Human Resources and Social Security, the Ministry of Finance, and the National Health Commission jointly issued the "Notice on Carrying out the Pilot Work of Direct Settlement of Work-related Injury Insurance for Cross-provincial and Non-local Medical Treatment" - from April 1, 2024, a one-year pilot project of direct settlement of work-related injury insurance for cross-provincial and non-local medical treatment will be launched in some cities.

The reporter learned that the whole area of injured workers in Chongqing was included in the pilot scope, and the First People's Hospital of Chongqing High-tech Zone was included in the first batch of pilot agreement institutions.

What is the direct settlement of work-related injury insurance for cross-provincial and non-local medical treatment, who can enjoy the direct settlement of medical treatment in other places, and what should I do? The relevant person in charge of the Social Security Affairs Department of the Government Service and Social Affairs Center of Chongqing High-tech Zone will answer your questions.

What is direct settlement of work-related injury insurance for cross-provincial and non-local medical treatment?

According to the relevant person in charge of the Social Security Affairs Department of the Government Service and Social Affairs Center of Chongqing High-tech Zone, after the injured employees go through the filing procedures for cross-provincial and remote medical treatment, they can be directly settled by swiping their social security cards (including electronic social security cards) if they are hospitalized for treatment of work-related injuries and rehabilitation of work-related injuries in the work-related injury agreement institutions outside the city. The part that should be borne by the work-related injury insurance fund shall be settled by the social security agency at the place of medical treatment and the social security agency at the place of insurance through the system, and shall no longer be reimbursed by the work-injured employee in advance.

In other words, the employee himself does not need to run errands back and forth between the place of insurance and the place of medical treatment for reimbursement, and the efficiency of medical treatment is higher.

Who can enjoy direct billing for remote medical treatment?

The following work-related injury employees who have participated in the city's work-related injury insurance and have completed the work-related injury identification, work-related injury recurrence confirmation, work-related injury rehabilitation confirmation or assistive device configuration confirmation can apply for direct settlement for cross-provincial and remote medical treatment:

(1) Employees with work-related injuries who live (work) in other places for a long time: refer to employees who have lived (worked) outside the city for half a year (inclusive) or more, and meet the requirements for medical treatment, rehabilitation, and assistive devices in other places in our city;

(2) Employees injured at work who are referred to and transferred to hospitals in other places: refer to the injured employees who cannot be diagnosed or equipped with medical technology and equipment limited to medical technology and equipment, and meet the requirements of referral and transfer in our city.

Who are the pilot agreement institutions and where can I find them?

The National Social Insurance Public Service Platform, the Government Service Platform of Human Resources and Social Security, the "Pocket 12333" APP, and the "Chongqing Human Resources and Social Security" APP have opened the query function related to the direct settlement of work-related injury insurance for medical treatment in other places, and employees with work-related injuries can inquire about the information of pilot agreement institutions, social security institutions and pilot cities through the click of a finger.

(1) PC:

Log in to the National Social Security Public Service Platform and the Human Resources and Social Security Government Service Platform (click to enter), and you can find the query function in the "Work-related Injury Insurance" column.

Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!
Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!

(2) Mobile phone:

Log in to the "Pocket 12333" APP and the "Chongqing Human Resources and Social Security" APP, enter the electronic social security card page, and enter the keyword "work-related injury" in the search bar, and the query entry will be displayed.

Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!

How to go through the filing procedures for direct settlement of medical treatment for work-related injuries in other places?

The relevant person in charge of the Social Security Affairs Department of the Government Service and Social Affairs Center of Chongqing High-tech Zone specially reminded that employees with work-related injuries should file with the social security agency of the county in the insured area before seeking medical treatment in other provinces and counties before they can be settled directly for medical treatment in other places.

Both online and offline ICP filing applications can be made.

Online: Employees with work-related injuries can handle it conveniently through the national social insurance public service platform, the government service platform of human resources and social security, the "Pocket 12333" APP, and the "Chongqing Human Resources and Social Security" APP.

Offline: The window of the social security agency of the county in the insured area can also handle the filing procedures for medical treatment in other places.

Editor-in-chief: Deng Xiaowei丨Deputy editor-in-chief: Li Haoyang

Editor-in-Chief: Li Tongtong丨Editor-in-charge: Wang Qian

记者:吴富强 | 编辑:雷鸣|校对:周翌

Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!

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Employees with work-related injuries are directly settled for medical treatment in other places, and they don't have to run back!