27 provinces to carry out the general outpatient fee cross-provincial direct settlement trial operation

Medical Network February 2, the State Health Insurance Bureau, the Ministry of Finance issued a joint notice, clearly added Shanxi, Inner Mongolia and other 15 provinces for outpatient expenses across the province direct settlement pilot provinces.
February 1, a total of 27 provinces (districts and cities) in China can rely on the national off-site medical settlement system to carry out a unified trial operation of direct settlement of general outpatient expenses across provinces.
27 provinces have carried out cross-provincial direct settlement trial operation of general outpatient fees since 2018, the Yangtze River Delta, Beijing-Tianjin-Hebei, southwest five provinces have successively carried out the region's general outpatient expenses cross-provincial direct settlement pilot.
Data from the State Health Insurance Administration show that by the end of 2020, all the co-ordination areas in Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang, Anhui, Chongqing and Yunnan, as well as some co-ordination areas in Sichuan, Guizhou and Tibet, had opened more than 10,000 direct settlement medical institutions and fixed-point retail pharmacies across provinces, with a cumulative total of more than 3 million direct settlements.
1st, the State Health Insurance Administration and the Ministry of Finance issued a notice on the list of pilot provinces for direct settlement of new outpatient expenses across provinces.
The Notice makes it clear that 15 provinces in Shanxi, Inner Mongolia, Liaoning, Jilin, Heilongjiang, Fujian, Jiangxi, Shandong, Hubei, Guangxi, Hainan, Shaanxi, Qinghai, Ningxia and Xinjiang are pilot provinces for direct settlement of outpatient expenses across provinces.
1 February 2021, the pilot operation of direct settlement of general outpatient expenses across provinces will be carried out.
the addition of 15 provinces and districts as a pilot province for direct settlement of general outpatient expenses across provinces, the first batch of 89 co-ordination areas, 663 fixed-point pharmaceutical institutions.
addition, on the same day, the State Health Insurance Administration issued "on the Unicom Beijing-Tianjin-Hebei, Yangtze River Delta, southwest five provinces of general outpatient expenses cross-provincial direct settlement services notice" was also announced. the
document makes it clear that the co-ordination areas of 11 provinces (regions and cities) including Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang, Anhui, Chongqing, Sichuan, Yunnan and Tibet, as well as the Hmong Autonomous Prefectures of Guizhou Province and southwestern Fujian Province, are all connected to the national off-site medical settlement system and are connected to the inter-provincial direct settlement of general outpatient expenses.
, 102,000 cross-provincial direct settlement fixed-point medical institutions and 118,000 fixed-point pharmacies were opened.
trial operation will also be launched on February 1, 2021.
February 1, the above-mentioned 27 provinces (regions and cities) rely on the national off-site medical settlement system to carry out a unified general outpatient expenses (excluding outpatient chronic special diseases) cross-provincial direct settlement trial operation.
By the end of 2021, the basic realization of cross-provincial direct settlement of outpatient expenses according to huang Huabo, director of the fund supervision department of the State Health Insurance Administration, introduced in September last year, on the basis of the pilot, the State Health Insurance Bureau will comprehensively promote the cross-provincial direct settlement of outpatient expenses, to ensure that by the end of 2021 the basic realization of cross-provincial direct settlement of outpatient expenses, to provide more convenient and efficient, in-patient outpatient integration of direct settlement services.
, what preparations do you need to complete to successfully enjoy the direct settlement of off-site medical expenses? According to the State Administration of Medical Insurance, basic medical insurance has been handled across the provinces for the direct settlement of inpatient medical expenses for the record personnel to open the general outpatient expenses direct settlement services simultaneously, without the need for additional records.
Other persons with the need for off-site general outpatient medical treatment shall be required to file for off-site medical treatment in accordance with the requirements of the management of off-site medical treatment in the insured places, and may be settled directly in accordance with the provisions when seeking medical treatment at the pilot fixed-point medical institutions in the above-mentioned pilot areas.
addition, the outpatient expenses directly settled by medical personnel from different provinces shall, in principle, implement the scope of payment and relevant provisions prescribed by the place of medical treatment (the scope of payment of basic medical insurance drugs, medical services items and medical supplies, etc.).
the provisions of the insured area shall be implemented in accordance with the reimbursement policies of the basic medical insurance fund, such as the starting standard, the proportion of payment and the maximum payment limit.
According to the introduction, the National Health Insurance Administration to develop the online national medical insurance service platform APP can provide off-site medical filing function, 22 provinces of 170 co-ordination areas can rely on the national unified online filing channels for filing, at the same time can be online inquiries to open the general outpatient pilot of the co-ordination area and fixed-point pharmaceutical institutions.
to protect the rights and interests of the insured personnel, the original reimbursement channels are retained for the direct settlement of unsuccessful expenses during the trial run.