1. application and registration: flexible employees should go to the medical insurance bureau to handle the morning paper and register with the original and photocopy of their ID cards. After the approval, we will handle everyone's medical guarantee, card and special office.
2. Approved payment: According to the application and registration of flexible employees, the Municipal Medical Insurance Bureau will verify according to the regulations and fill in the payment verification form.
3. Payment process: Flexible employees pay directly to the tax hall of the Municipal Local Taxation Bureau with the payment approval form stamped with the special seal of the Medical Insurance Bureau. The fee ticket is transmitted from the Municipal Local Taxation Bureau to the Municipal Labor Settlement Center, and the Municipal Labor Settlement Center is transmitted to the Medical Insurance Bureau. The medical insurance bureau regularly transmits the payment verification data of flexible employees to the labor settlement center once a month.
Second, the medical treatment process
(1) hospitalized
1, with the Medical Insurance Certificate and the Medical Insurance Card (the required certificates and cards are complete), go to the designated hospital to pay the outpatient registration fee for outpatient treatment.
2, the attending physician in the "medical insurance certificate" in the "medical history and diagnosis and treatment records" recorded in the main illness, inspection (inspection) results and treatment; According to the condition of patients who need hospitalization, hospitalization certificate issued by the attending physician.
3. Submit the medical guarantee, medical insurance card and hospitalization certificate to the designated hospital medical insurance charging office (admission registration office) for registration, and the hospital will upload the hospitalization application information to the medical insurance bureau online (the medical guarantee and medical insurance card are left at the entrance and exit of the hospital).
4. The inpatients in the county people's hospital shall go through the hospitalization examination and approval formalities with the hospitalization certificate, unit introduction letter, inspection report and laboratory test sheet at the business hall of the medical insurance bureau (opposite to Mao Zedong's former residence in the county people's hospital, tel: 62 1956 1); In other hospitals in the county, the hospital will fax the hospitalization certificate and inspection (inspection) data to the business hall of the medical insurance bureau, and the medical insurance bureau will approve it online. Patients do not need to go to the medical insurance bureau for examination and approval procedures; Emergency patients who have no time to go through the hospitalization examination and approval procedures can be hospitalized first and complete the hospitalization examination and approval procedures within three days.
5. Pay a certain hospitalization deposit at the settlement office at the entrance and exit of the hospital. Pay the deposit in full if the medical expenses are less than 1 ,000 yuan, and pay 50% if the medical expenses are more than 1 ,000 yuan. Medical expenses incurred during hospitalization, medical expenses below the Qifubiaozhun of the medical insurance pooling fund (hereinafter referred to as "self-paid part"), personal burden and unit burden of the insured, self-funded drugs and self-funded expenses are settled by the insured and the hospital in cash, and medical expenses paid by the medical insurance pooling fund (i.e. medical insurance reimbursement part) are accounted by the hospital and settled by the hospital and the medical insurance bureau; The minimum qifubiaozhun of the medical insurance pooling fund (referred to as "self-payment period" for short) is: the first hospitalization in the county, the first-level medical institution (township hospital) in 500 yuan, the second-level medical institution (county hospital) in 600 yuan, the third-level medical institution and the medical institution outside the county in 700 yuan; The second hospitalization is 80% of the first hospitalization Qifubiaozhun; The third hospitalization is 60% of the first hospitalization Qifubiaozhun. When the hospital deposit is discharged, it will be refunded more and replenished less according to the settlement.
6, in the county people's hospital during hospitalization need to do special examination and treatment (refers to a single examination and treatment project 100 yuan or more, including 100 yuan), by the attending physician issued the special examination and treatment approval form, after being signed by the director and dean of the hospital department, reported to the medical insurance bureau for examination and approval; In other hospitals in the county, the hospital will fax the Approval Form for Special Examination and Treatment to the business hall of the Medical Insurance Bureau, and the Medical Insurance Bureau will approve it online. Patients do not need to go to the medical insurance bureau for examination and approval procedures; Emergency patients who have no time to go through the examination and approval procedures can be examined or treated first, and the examination and approval procedures for special examination and treatment will be completed within three days.
7. When the patient is discharged from the hospital, he/she will go to the entry-exit settlement office of the hospital for discharge settlement, refund the overpaid hospitalization deposit or pay the underpaid fee; Get the settlement documents printed by the hospital (the company's reimbursement form) and get back the medical guarantee and medical insurance card.
8. When the insured is unable to make a diagnosis and treatment in the county hospital and needs to be referred to other hospitals, the attending doctor of the hospital shall fill in the Approval Form for Referral. After the director and dean sign the opinions, they shall go through the referral procedures in the business hall of the Medical Insurance Bureau with the medical guarantee, medical insurance card, letter of introduction from the unit, inspection and testing, and the "Approval Form for Referral" issued by the hospital. After approval, it can be transferred to a higher hospital for diagnosis and treatment.
(2) Outpatient service
This place is different, but as long as you bring the social security medical insurance slip and medical insurance card, you can tell the doctor that you have medical insurance when you see a doctor.