Outpatient expenses are directly settled across provinces and enter the "fast lane"

Focus on the medical settlement needs of 125 million inter-provincial floating population
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The direct settlement of medical treatment across provinces and other places is progressing in an orderly manner, and various measures are being further promoted, which will further facilitate medical treatment and expense reimbursement for people working and living in different places across provinces
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According to the National Medical Security Administration, as of now, the direct settlement of hospitalization expenses for medical treatment in different places across provinces has covered the whole country.
On this basis, the National Medical Insurance Agency has clearly refined the basic policy of direct settlement of outpatient expenses across provinces, and promoted general outpatient clinics and outpatient chronic diseases according to classification.
Cross-province direct settlement of expenses
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In terms of general outpatient clinics, at the beginning of this year, the Beijing-Tianjin-Hebei, Yangtze River Delta, and Southwestern five provinces were fully opened up for pilot trials, and the scope of the pilots was further expanded.
15 provinces including Shanxi were added as national outpatient pilot provinces
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At present, 97.
6% of the overall planning area and 120,000 designated medical institutions have been covered, 91.
7% of the counties have more than one networked designated medical institutions, and the cumulative settlement of outpatient clinics has exceeded 10 million
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In terms of outpatient chronic diseases, in September this year, five kinds of outpatient chronic diseases related treatment costs including hypertension, diabetes, malignant tumor radiotherapy and chemotherapy, uremic dialysis, and anti-rejection therapy after organ transplantation were launched across the provinces.
The direct settlement of medical treatment in different places, and the pilot settlement of direct settlement of 5 types of outpatients for chronic and specific diseases have opened in Beijing, Tianjin, Hainan Province, and a total of 15 coordinating areas, and it is expected to cover all coordinating areas by the end of next year
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Long Xuewen, person in charge of the Medical Security Management Center of the National Medical Security Administration: Outpatient chronic diseases are indeed "hard bones".
The frequency of medical treatment is very high, the timeliness is very strong, immediate medical treatment, and immediate settlement.
Relatively large
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According to reports, outpatient expenses and hospitalization expenses are the same in the cross-provincial direct settlement policy, "list of medical places, policy of insured places, and management of medical places"
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To put it simply, when seeking medical treatment in different places across provinces, which medical insurance can be claimed shall be in accordance with the regulations of the place of medical treatment, but the reimbursement ratio and the maximum amount of reimbursement shall be in accordance with the regulations of the place of enrollment.

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Long Xuewen, person in charge of the Medical Security Management Center of the National Medical Security Administration: For these outpatient expenses that cannot be directly settled, we are exploring and researching through online channels, such as the National Medical Insurance Service Platform APP, to transmit relevant bills and information from the doctor’s place Return to the insured area to shorten the reimbursement time
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The National Medical Insurance Bureau stated that the current direct settlement of medical treatment in different places across provinces has expanded from hospitalization to outpatient clinics, and the process has also expanded from offline manual settlement to online direct settlement
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The cross-provincial direct settlement process of outpatient expenses has changed from "filing first, selecting a point, and seeking medical treatment with a card" to "first filing, selecting a point, and seek medical treatment with a card code", which reflects that the settlement process is more optimized and convenient
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Cross-provincial direct settlement of outpatient medical treatment in different places has moved from a regional pilot to a national pilot, and it will soon achieve full coverage of the overall planning area.
Through multiple measures such as opening up blocking points and solving difficulties, it will accelerate the direct settlement of outpatient expenses across provinces
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