First, understand the medical insurance policy and the scope of reimbursement
First of all, patients need to know the relevant policies of Guangzhou medical insurance, including the scope, proportion and limit of outpatient reimbursement. Guangzhou medical insurance outpatient reimbursement usually covers basic medical services, but there are also some special items that may not be covered by reimbursement, so patients need to know carefully before seeking medical treatment.
Second, choose designated medical institutions for medical insurance
In order to enjoy medical insurance outpatient reimbursement, patients need to choose the designated medical institutions in Guangzhou for medical treatment. These medical institutions have signed a service agreement with the medical insurance department, which can provide medical insurance services for patients in accordance with regulations.
Third, seek medical treatment and keep relevant documents.
When patients seek medical treatment in designated medical institutions, they should take the initiative to show their medical insurance cards and keep all documents related to medical treatment, such as invoices, prescriptions and inspection reports. These vouchers are an important basis for subsequent reimbursement.
Fourth, go through the reimbursement procedures.
After seeing a doctor, patients need to bring relevant vouchers to the medical insurance department for reimbursement. When reimbursing, you need to fill in the reimbursement application form and submit relevant vouchers. The medical insurance department will review the submitted materials and reimburse them according to the policy.
Verb (abbreviation of verb) inquires about reimbursement progress and results.
Patients can check the reimbursement progress and results through official website of Guangzhou Medical Insurance Department or by telephone. Once the reimbursement is successful, the patient will receive the corresponding reimbursement.
To sum up:
Guangzhou medical insurance outpatient reimbursement requires patients to understand the medical insurance policy and scope of reimbursement, choose designated medical institutions for medical treatment, keep relevant vouchers, go through reimbursement procedures, and inquire about the progress and results of reimbursement. Through these steps, patients can effectively use Guangzhou medical insurance system and reduce the burden of medical expenses.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
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.
Measures of Guangzhou Municipality on Social Medical Insurance
Article 26 provides that:
The medical expenses incurred by the insured in using basic medical insurance drugs, diagnosis and treatment items and medical service facilities shall be paid by the social medical insurance pooling fund in accordance with the following provisions:
(a) belongs to a class of drugs and popular diagnosis and treatment projects, paid by the overall fund in accordance with the provisions of these measures; Belonging to Class B drugs or special treatment projects, the insured person shall pay in proportion first, and then pay according to the provisions of these measures; Belong to class C drugs or self-funded medical projects, paid by the insured individual.
(two) medical expenses that belong to the standard of basic medical service facilities shall be paid by the overall fund according to the provisions of these measures.