Please check this tip about direct settlement of medical treatment in different places
According to data released by the National Medical Insurance Administration, in the first quarter of 2023, 1.7105 million people were successfully filed through the national unified online filing channel. At present, all employee medical insurance and resident medical insurance participants can use the National Medical Insurance Service Platform App and the WeChat official account of the National Medical Insurance Bureau to achieve online filing for cross-provincial and remote medical treatment.
Some patients have raised questions about filing records for medical treatment in different places, settlement of chronic and special diseases in outpatient clinics, etc. The National Medical Insurance Bureau recently gave answers to some common questions.
Question: When going through the filing for medical treatment in other places, it is prompted that “the information has been filed and there is no need to file again”. However, the insured has never done online filing, and relatives and friends may have helped to handle it a long time ago. Where can I find effective filing information?
A: Log in to the App of the National Medical Insurance Service Platform or the WeChat applet of the National Off-site Medical Record Filing, click on the online “Off-site Filing” to enter the off-site filing area, and then click the[Record]button at the bottom of the page to enter the off-site medical record record page to query the off-site medical record state. There are three options at the top of the page, the first two options “quick filing” and “self-service activation” are query options for filing in the national unified filing channels (including the National Medical Insurance Service Platform App, the WeChat official account of the National Medical Insurance Bureau, etc.), you can query The progress and results of previous online filings, the third option “Local Platform” is an online filing channel developed by the local medical insurance department or an inquiry option handled on-site by the medical insurance agency in the insurance area. You can choose to query the effective filing status. Including the place of filing and the validity period of filing.
Picture from the official website of the National Medical Insurance Administration.
It is recommended that the insured person find the “local platform” filing record in the National Medical Insurance Service Platform App before online filing or when the online filing prompts that the filing has been completed to understand their effective filing status.
Question: In addition to the five outpatient chronic special diseases, such as hypertension, diabetes, malignant tumor outpatient radiotherapy and chemotherapy, uremia dialysis, and anti-rejection treatment after organ transplantation, if the insured person has other outpatient chronic special disease treatment qualifications, How should I pay when I see a doctor for a related disease?
Answer: At present, on the basis of the full coverage of general outpatient expenses directly settled across provinces, all coordinated regions across the country have realized high blood pressure, diabetes, malignant tumor outpatient radiotherapy and chemotherapy, uremia dialysis, and anti-rejection treatment after organ transplantation, etc. Cross-provincial direct settlement of treatment expenses related to 5 outpatient chronic diseases. If the insured person has the qualifications for outpatient treatment of chronic special diseases other than the above 5 types, be careful not to settle directly across provinces according to ordinary outpatient expenses when seeing related diseases in different places, and must pay the full amount at the designated medical institution according to the regulations of the insured place, and return Manual reimbursement at the insured place.
If you want to know your eligibility for outpatient treatment for chronic special diseases, you can log in to the App of the National Medical Insurance Service Platform to inquire.