Shulou(Shulou.com)11/24 Report--

CTOnews.com, June 19, National Healthcare Security Administration recently announced the notice on the implementation of 16 convenient measures for health insurance services (hereinafter referred to as the "notice"), aiming at the transfer and continuation of health insurance relations, direct settlement of medical treatment in different places, inquiry of health insurance information, and electronic vouchers for medical treatment and medicine purchase, simplify procedures, streamline materials, reduce time limits, and innovate service models.

The sixteen convenience measures in the notice attached to CTOnews.com are as follows:

(1) to optimize the transfer and succession of medical insurance relations.

1. Simplify the procedure. Cancel the requirement of issuing "basic medical insurance participation certificate" and "basic medical insurance relationship transfer connection letter" in the inter-provincial transfer of basic medical insurance.

2. Shorten the time limit for handling. The inter-provincial transfer time of basic medical insurance has been reduced from 45 working days to 15 working days.

3. The insured no longer need to run on both sides of the transfer and exit, and can independently choose to handle it online or to the nearest window of the agency window of the transfer and exit, and can apply online and inquire about the progress at any time.

(2) to simplify the filing process of medical treatment in other places and improve the settlement service of medical treatment in other places.

4. it is convenient for the masses to apply for medical records in different places through multiple channels. Insured personnel can apply for remote medical records through online channels such as the national health insurance service platform App and the national remote medical record Mini Program.

5. After the registration and filing of long-term residents in different provinces, the record shall be valid for a long time if they have not applied for change for the record or have not changed their insurance status. Within the period of validity of the record, you can seek medical treatment many times at the place of medical treatment and enjoy the direct settlement service of cross-provincial medical treatment in different places.

6. If the insured persons do not apply for medical records in different places before hospitalization, they may apply for registration and filing procedures under the guidance of designated medical institutions, and if registration is completed before discharge, cross-provincial network designated medical institutions shall provide direct settlement services for cross-provincial medical treatment in different places.

7. in the event of emergency rescue, the insured who do not apply for the record of medical treatment in different places shall be regarded as having been put on record, and the insured shall be allowed to settle the relevant outpatient and hospitalization medical expenses directly according to the relevant treatment standards of emergency rescue in different places.

8. If the insured personnel who seek medical treatment in different places across the province go through the formalities for filing at their own expense after being discharged from the hospital, they may apply for reimbursement of medical insurance manually according to the provisions of the place where they are insured.

9. When the insured apply for medical treatment in different places for the record, they shall directly put on record to the cities where they seek medical treatment or municipalities directly under the Central Government, and all inter-provincial network designated medical institutions opened in the place of filing enjoy inter-provincial direct settlement of hospitalization expenses.

10. Long-term residents of different provinces are allowed to enjoy two-way treatment in both the filing place and the place where they participate in the insurance. If long-term residents in different provinces really need to return to the insured place for medical treatment within the period of validity of the record, they can also enjoy the medical insurance settlement service in the insured place.

11. Participants who are qualified for hypertension, diabetes, radiotherapy and chemotherapy in malignant tumor clinic, uremia dialysis and anti-rejection treatment after organ transplantation can open cross-provincial networking designated medical institutions for chronic diseases in relevant outpatient clinics, enjoy the cross-provincial direct settlement of the relevant treatment costs.

(3) to promote the "one-window access" of medical insurance agency services.

12. To promote the "comprehensive teller system" of the health insurance agency service window, the front desk of the window does not distinguish between types of insurance, matters, one-window acceptance, one-stop service, and backstage offices are divided into joint offices and express offices, allowing the masses to enter a door, take a number, and do it in one window.

(4) to promote the "online handling" of high-frequency service matters.

13. It is convenient for insured people and insured units to handle affairs online. Rely on the health insurance service platform "personal network hall" and "unit network hall" to realize the "online operation" of high-frequency service items in the medical insurance field, such as registration and change of insurance information, so as to improve the network hosting rate.

(5) to open various channels to meet the needs of the masses in inquiring about medical insurance information.

14. The insured can inquire about personal payment records, personal medical insurance accounts, cross-provincial medical settlement services, medical insurance drug catalogues and other information on the national health insurance service platform App, network hall or local health insurance service platform.

15. Medical insurance self-service areas shall be set up in the halls of medical insurance agencies and qualified bank outlets, community service centers, designated medical institutions and retail pharmacies, so as to facilitate the masses to inquire about personal contributions, account balances and other health insurance information concerned by the masses.

(6) to facilitate the masses to seek medical treatment and purchase medicines.

16. Promote the application of electronic medical insurance vouchers in the whole process of medical treatment and drug purchase. The insured do not need to hold a physical card, but can see a doctor and buy medicine with a QR code or a facial scan.

The circular said: "We should extensively listen to the views of the insured and people from all walks of life, carry out targeted research, and take effective measures to respond to the expectations of the masses and meet the reasonable needs of the masses." define the division of responsibilities, improve the working mechanism, work out a timetable, and implement it well, so as to ensure new breakthroughs and achievements in convenient services by the end of August 2023. "

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