Taking Linyi as an example, the new rural cooperative medical system can be reimbursed across provinces.
according to article 23 of the basic medical insurance measures for Linyi residents, the insured residents go to the designated medical institutions for medical treatment with social security cards or second-generation identity cards, and the designated medical institutions are responsible for verifying the insured status and implementing immediate settlement after discharge according to the policy. The expenses that should be paid by the residents' basic medical insurance fund shall be settled by the agency and the designated medical institution.
the hospitalization expenses incurred by insured residents in designated medical institutions without instant settlement function (including medical treatment in different places) shall be paid in advance by the insured residents. After the treatment is over, they shall go through the examination and reimbursement procedures with relevant information in time at the handling institution of the insured place, and report it before the end of February of the following year at the latest, and will not be handled after the deadline.
Insured residents should implement the system of primary consultation, graded diagnosis and treatment and step-by-step referral, and generally follow the principle of "first in the county, then in the city and outside the market". If the city needs to handle but fails to handle the referral filing procedures according to the regulations, the reimbursement ratio of the corresponding level hospitals will be reduced by 1 percentage points.
if the insured residents need to be transferred to designated medical institutions outside the city for hospitalization due to special illness, the designated medical institutions at the second level or above in the insured area shall issue a certificate of transfer and report it to the county-level handling institution for the record. Insured residents who need to be hospitalized (transferred) for treatment in different places or due to acute and dangerous diseases shall go through the relevant formalities with the handling agency of the insured place according to the above provisions within 5 working days from the date of hospitalization.
Extended information:
Taking Linyi as an example, the new rural cooperative medical system can be reimbursed across provinces.
especially those who are transferred to the municipal extranet hospital for hospitalization, it shall be implemented in accordance with the relevant regulations of the higher authorities on remote network settlement. Transferred to the non-networked designated hospitals outside the city for hospitalization, the transfer registration formalities shall be handled in accordance with the regulations, and the individual pays 1% of the medical expenses within the scope of the policy, and the Qifubiaozhun and reimbursement ratio for hospitalization in the three-level designated hospitals in the city shall be implemented.
if a person is transferred to a non-networked designated hospital outside the city for hospitalization but fails to go through the referral filing formalities according to the regulations, if the investigation is true, the individual shall pay 2% of the medical expenses within the scope of the policy first, and the hospitalization Qifubiaozhun and reimbursement ratio of the three-level designated hospitals in the city shall be implemented.
Linyi Human Resources and Social Security Bureau-Measures on Printing and Distributing the Basic Medical Insurance for Linyi Residents