Yesterday, the reporter learned from the Municipal Medical Insurance Bureau that in order to do a good job of carrying over the basic medical insurance for urban employees and urban and rural residents in 2019, and to ensure that the city's basic medical insurance participants can smoothly visit social insurance cards for medical treatment and purchase drugs, I The city medical insurance information system will be shut down from 00:00 on January 1, 2020 to 24:00 on January 5, 2020.
During the shutdown period, all designated medical insurance designated hospitals and designated retail pharmacies in Ningde City will temporarily suspend all medical insurance card settlement services such as outpatient medical treatment, inpatient treatment, and purchase of drugs in pharmacies, and suspend the insured personnel in our city. Seek medical insurance network settlement business. If the carry-over work is completed ahead of time, the medical insurance system will be turned on in advance and all business will be resumed accordingly.
During the shutdown period, insured persons who are admitted before December 1, 2019 should be settled by credit card and registered for discharge before December 31, 2019; those who are admitted after December 1, 2019 and need to be hospitalized for multiple years should be hospitalized in December 2019 The mid-term settlement is processed before March 31, and the hospitalization expenses incurred during the shutdown period are included in the 2020 hospitalization medical expenses. The insured person's hospitalization across the year is regarded as one hospitalization, and the threshold and the number of hospitalizations are counted only once. The payment line, reimbursement ratio, and overall benefits are implemented according to the annual policy of the actual hospitalization charge date, and the number of hospitalizations is counted in 2019. If the hospitalization is paid by disease type for multiple years, the insured should cooperate with the hospital to cancel the admission registration in 2019 and write off the settled expenses, and re-swipe the card to be admitted to the hospital after the carry-over in 2020. The hospitalization expenses incurred during the shutdown period are included in the 2020 hospitalization. Medical fees.
In addition, for trauma patients who are admitted to hospital in 2019 and need to be hospitalized for multiple years, and pay for each type of disease, the patients who are insured and withdrawn from a single disease will be included in the year of the settlement date of discharge. The reimbursement ratio and overall treatment shall be implemented in accordance with the annual policy of the discharge settlement date. For insured patients who are admitted to hospitals across different provinces (including direct credit card and manual reimbursement) for multiple years, all hospitalization costs are included in the cumulative annual medical expenses for the settlement date of discharge. The medical expenses incurred by outpatients and inpatients during the shutdown period will be settled by the designated hospitals after the system is turned on. The insured patients will be required to settle medical expenses due to special circumstances such as referrals, referrals, and emergency treatment during the shutdown period. If necessary, advance payment can be made by the individual first, and after the system is turned on, carry relevant materials to the medical insurance agency of the participating place for manual reimbursement. Patients suffering from uremia who need to undergo outpatient hemodialysis treatment during downtime should apply for advance payment to designated hospitals on December 30 and 31, 2019 (to ensure that hemodialysis patients receive free treatment twice a week will not be affected). Overdue credit cards will not be settled.
The staff of the Municipal Medical Insurance Bureau reminded that the medical expenses of the city's basic medical insurance participants who are not reimbursed in 2019 should be submitted before March 31, 2020, and will not be accepted after the deadline. During the downtime, the city's medical insurance service window will temporarily suspend the processing of various services that need to be operated on the medical insurance information system. (Reporter Chen Wei)