First, contact medical insurance agencies or designated medical institutions.
When medical insurance cannot be reimbursed, you should first contact the local medical insurance agency or the designated medical institution that is seeking medical treatment. Through the consultation window, service hotline or official website, you can know the specific reimbursement policies, procedures and standards, as well as the reasons for your own reimbursement failure.
Second, verify personal information and reimbursement materials.
During the consultation process, carefully check whether your personal information and submitted reimbursement materials are accurate. Sometimes, the failure of reimbursement may be due to incorrect personal information, lack of necessary reimbursement materials or unqualified materials.
Three. Ways and methods of complaint
If, after verification, you think that your rights and interests have been infringed or there is a problem with the medical insurance service, you can choose the following channels to make a complaint:
1. Complain to the medical insurance agency: You can go to the complaint window of the medical insurance agency or call the complaint number to reflect the problem to the staff and make a complaint.
2. Complain to designated medical institutions: If you encounter problems in the process of medical treatment, you can report the situation to the complaint department or management department of the hospital where you are located.
3. Complain to relevant departments: If you think that the medical insurance agency or designated medical institution has failed to properly solve the problem, you can complain to the local health department, medical security department or consumer rights protection department.
When making a complaint, you should provide detailed personal information, problem description, relevant evidence and contact information so that relevant departments can handle and reply in time.
Fourth, safeguard their own rights and interests.
During the whole complaint process, we should remain calm and rational, and respect the labor and rights of employees. At the same time, we should actively safeguard our legitimate rights and interests and don't give up our demands easily.
To sum up:
If the medical insurance fails to report the time, you should first contact the medical insurance agency or the designated medical institution for consultation and verification. If you think that your rights and interests have been infringed, or there are problems with medical insurance services, you can choose to complain to relevant departments to safeguard your legitimate rights and interests. In the process of complaint, detailed information should be provided and the labor and rights of employees should be respected.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 82 provides that:
Any organization or individual has the right to report and complain about violations of social insurance laws and regulations. Social insurance administrative departments, health administrative departments, social insurance agencies, social insurance fee collection agencies, financial departments and audit institutions shall, within the scope of their respective functions and duties, handle reports and complaints according to law; If it is not within the scope of responsibilities of the department or institution, it shall be informed in writing and handed over to the department or institution that has the right to handle it. Departments and institutions that have the right to deal with it shall deal with it in time and shall not shirk it.
Regulations on the supervision and administration of the use of medical insurance funds
Article 30 provides that:
Citizens, legal persons or other organizations have the right to report and complain about violations of laws and regulations of medical insurance funds. The administrative department of medical security shall smooth the channels for reporting and complaining, handle relevant reports and complaints in a timely manner according to law, and keep the information of informants confidential.