In some hospitals, when patients receive medical services, the hospital will first deduct the medical insurance reimbursement from the medical expenses paid by the patients, and then pay the remaining expenses from the hospital fund. This can reduce the financial burden of patients, improve the quality of medical services and promote the harmony between doctors and patients.
The hospital fund payment process is as follows:
1, the hospital makes a list of medical service expenses: when providing medical services for patients, the hospital needs to make a list of medical service expenses, including treatment expenses, examination expenses and medicine expenses.
2. The hospital submits the expense list to the fund management institution: the hospital submits the patient's medical service expense list to the medical insurance fund management institution for review;
3. Audit of the expense list by the fund management institution: The fund management institution shall audit the expense list submitted by the hospital to confirm the authenticity, rationality and standardization of the expenses;
4. The fund management institution pays fees to the hospital: after approval, the fund management institution pays fees to the hospital, and the hospital collects medical expenses from patients according to the actual situation.
To sum up, the hospital fund payment process may be different due to different regions and medical insurance policies, and the specific details need to be inquired and handled according to the actual situation. At the same time, patients should consult the relevant policies of hospitals and fund management institutions to understand their medical insurance benefits and payment methods, so as to better manage their medical expenses.
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.
Medical insurance is one of the five social security in China. Medical insurance fund refers to the monetary fund that enterprises, institutions, organizations or individuals who participate in medical insurance raise and pay the prescribed amount of medical insurance premiums in the form of laws or contracts to provide basic medical insurance for the insured. The collection and management of medical insurance fund is compulsory.