the medical insurance statement is a list of data submitted by the hospital when it applies to the medical insurance department for expense settlement.

The list mainly includes the following contents:

1. Basic information part: 32 items

2. Outpatient information part: 6 items

3. Inpatient information part: 57 items

4. Medical charge information part: 95 items

In addition to the above indicators, most of the indicators in the medical insurance statement are taken from the first page of inpatient medical records. In addition, medical insurance statements and expense lists are often used in commercial insurance medical claims, because commercial insurance will decide the proportion of claims according to whether medical insurance is included or not.

You can use the following methods to query the medical insurance statement:

1. Through the medical insurance applet, you can query personal medical insurance information, including enrollment, medical insurance, maternity insurance, personal account and annual cumulative reimbursement of medical insurance.

2. use the provincial government service app to enter the medical insurance account, and you can query the payment records and consumption records of the medical insurance account.

3. using the national medical insurance service platform app, you can query the personal medical insurance code and payment records.

to sum up: according to the medical insurance policy, the hospital should provide the insured with a medical insurance statement, and ask the insured to sign the medical insurance statement for confirmation. If it is not provided after settlement in the hospital, the hospital can be required to provide it.

Legal basis:

Article 28 of the Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers

Is the individual account used to pay for the overall fund? Medical expenses beyond the scope of payment; If the personal account is insufficient to pay, it shall be borne by me.

Article 29

Medical expenses for hospitalization of serious diseases shall be paid in the following ways: (1) Qifubiaozhun shall, in principle, be controlled at 9%-11% of the average social wage of employees in cities, counties and autonomous counties in the previous year. (two) the maximum payment limit is controlled in principle at 3-5 times of the average annual social wage of employees in cities, counties and autonomous counties. (three) medical expenses above the minimum threshold and below the maximum payment limit are mainly paid by the overall fund, and a certain proportion is borne by the individual. Give appropriate care to the proportion of retirees who bear medical expenses. The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the sharing ratio of medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.