Basic overall payment refers to the expenses reimbursed by medical insurance, that is, when insured persons enjoy medical insurance benefits, the medical insurance fund pays the medical expenses that meet the reimbursement conditions in accordance with the prescribed proportions and standards.

1. The concept of basic coordinated payment

Basic coordinated payment is an important part of the medical insurance system, aiming to provide insured persons with the guarantee of medical expense reimbursement. When insured persons seek medical treatment, medical expenses that meet the reimbursement conditions will be paid by the medical insurance fund, thus reducing the financial burden of insured persons.

2. Scope of application of basic coordinated payment

Basic coordinated payment is applicable to medical expenses that comply with the provisions of medical insurance policies, including hospitalization expenses, outpatient expenses, drug expenses, etc. Specific reimbursement coverage and rates vary by region and policy, but most common medical expenses are generally covered.

3. Reimbursement process for basic coordinated payment

When seeking medical treatment, insured persons need to bring their medical insurance cards or related documents to facilitate medical institutions to settle expenses. Medical institutions will conduct preliminary review and settlement of medical expenses that meet the reimbursement conditions in accordance with medical insurance policies. Subsequently, the medical insurance foundation will further review and pay the expense declaration submitted by the medical institution in accordance with relevant regulations.

IV. The significance of basic coordinated payment

The implementation of basic coordinated payment is of great significance for protecting the basic medical rights and interests of insured persons. It can not only reduce the financial burden of insured persons, but also promote the rational use of medical resources and improve the quality and efficiency of medical services.

In summary:

Basic overall payment is a fee reimbursed by medical insurance, which aims to provide insured persons with a guarantee of reimbursement of medical expenses. It applies to medical expenses that comply with medical insurance policies and follows certain reimbursement procedures. The implementation of basic overall payment is of great significance for protecting the basic medical rights and interests of insured persons, promoting the rational utilization of medical resources and improving the quality of medical services.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 28:

Compliance The basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

"Social Insurance Law of the People's Republic of China"

Article 30 stipulates:

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Should be paid from the work-related injury insurance fund;

(2) Should be borne by a third party;

(3) Should be paid by the company ***Health burden;

(4) Seeking medical treatment abroad.