1. When seeking medical treatment, you need to show your medical insurance card to the hospital and tell the doctor whether you need to use it to coordinate payment;
2. The doctor will prescribe the corresponding prescriptions and medical items according to the diagnosis and treatment, and then enter the cost information into the hospital's charging system;
3. The toll collector will check the charging information and tell you the amount that can be paid by using the medical insurance card as a whole. If you need to use the medical insurance card to pay, you need to explain to the toll collector when paying;
4. When using the medical insurance card as a whole for payment, you need to enter a password or perform authentication such as fingerprint verification. After the payment is successful, the hospital will upload the cost information to the local medical insurance center for reimbursement.
The process of medical insurance reimbursement:
1, medical treatment: go to a hospital or clinic for medical treatment or treatment;
2. Payment: Pay the medical expenses that should be paid in the hospital or clinic;
3. Obtain a list of expenses: during the medical treatment, the hospital or clinic will provide a list of expenses, which lists the specific medical items and amount;
4. Fill in the reimbursement application form: hold the expense list and fill in the medical insurance reimbursement application form. You need to provide your own basic information, medical expenses list, medical insurance certificate and other related materials when filling in;
5. Submit materials: submit the completed reimbursement application form and related materials to the medical insurance agency, which can be submitted online or offline;
6. Audit: The medical insurance agency shall audit the submitted application forms and materials. After the approval, the medical insurance agency will transfer the reimbursement funds into the personal bank account or give cash reimbursement.
To sum up, different regions and different medical insurance systems may have different participation conditions, payment standards and reimbursement scope. When participating in medical insurance, residents need to understand local laws and policies and consult the staff of local social insurance agencies.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.