FAQ of settlement in different places

1. What is the direct settlement of medical expenses of cross provincial and non local medical treatment and hospitalization of basic medical insurance (hereinafter referred to as direct settlement)?
A: direct settlement is a new expense reimbursement policy and settlement method established by the state to solve the problems of "advance payment, errand running, long reimbursement cycle" and so on in the manual reimbursement of medical expenses for medical treatment and hospitalization in different places of basic medical insurance participants. The insured of basic medical insurance (hereinafter referred to as the insured) who has gone through the direct settlement filing can directly settle the current hospitalization medical expenses through the national non local medical treatment settlement system when they are discharged from the designated medical institutions (hereinafter referred to as the designated medical institutions) of basic medical insurance in other provinces (municipalities directly under the central government, autonomous regions) selected for filing.

2. What is direct settlement filing? Why do we need to record the settlement directly?
A: direct settlement filing refers to the application of the insured and the approval of the handling agency, and the relevant information of the eligible insured is included in the national direct settlement filing personnel information base. Before seeking medical treatment in other places across the province, the insured should go to the local agency for registration. Only the insured who has been included in the national direct settlement filing personnel information database can implement direct settlement in the non local designated medical institutions that they have filed.

3. What is the specific reimbursement proportion of remote settlement?
Answer: the inpatient settlement and reimbursement implement the local drug catalogue, diagnosis and treatment items, the scope of medical service facilities and their payment standards; The minimum payment standard, payment proportion and maximum payment limit of the medical insurance fund shall be implemented in accordance with the policy standards of the place where the patient is insured