Hainan remote medical billing cooperation zone 223 reimbursement is no longer "two runs in our province through remote medical billing the" artery ", up to 223 remote medical billing is no longer" run two "Hainan Daily reporter Wang Peilin September 13th and cooperation zone, with the Provincial Social Security Bureau and Shanghai City Medical Center signed a cooperation agreement of remote medical treatment, I provincial remote medical cooperation and settlement of the area reached 223, covering all provincial districts (excluding Hong Kong and Macao). This is a milestone in the process of remote medical settlement in our province. The settlement of medical treatment in different places accords with the characteristics of the mobility of the modern people, and is an important item to help the construction of Hainan international tourism island. The provincial Party committee and the provincial government attached great importance to the project which affected the people, and upgraded it to the supervision project of the provincial governor. This year 4 month 21 day, governor Liu Cigui pointed out that the province should accelerate and provinces in remote medical billing work, and strive to achieve remote medical direct settlement in the country, and gradually promote the international remote medical billing. Remote medical billing from Shenyang people’s livelihood retired 72 year old retired from Qu Huali, went to Sanya to follow her son and his wife, 2014 sudden cerebral thrombosis before and after hospitalization, spend a few million yuan, the family only medical expenses can be reimbursed back Shenyang documents. The daughter of Yan Yahui through consultation, to help the elderly to apply for remote medical registration, since then, the old man in two hospitals in Sanya for medical treatment and medical insurance settlement directly. "Now every hospital can direct online settlement, to experience before rushing hard, can feel now remote medical billing convenience." Speaking of remote medical billing, Yan Yahui deep feelings. Remote medical billing cooperation covering all areas at the provincial level, means that Hainan is more open and inclusive, more and more people from other provinces to settle in Hainan and other provinces who work in Hainan home endowment insurance limit, will no longer be. "Objectively speaking, the rapid advance of remote medical treatment, and cooperation in our province to overall area sharing of medical resources in Hainan Province, and CO ordinating area, Huimin are good, will also attract more foreign people to settle in hainan." Provincial Social Security Bureau medical insurance department responsible person said. Hainan is a large population in China, especially in the 2009 Hainan international tourism island rises for national strategy, to settle, the number of vacation, Joan investment increase, in this regard, our province will develop a work plan, to explore a new way to do remote medical billing positioning project as the key point in human and financial supervision, and to be support, at the same time, inside and outside the province, the majority of the insured person for our province to remote medical billing in 2009 kicked off, and then Guangdong, Guangxi, Guizhou, Heilongjiang, Shanxi and other 5 provinces signed a cooperation agreement of remote medical billing. To explore the settlement diversification about agreements with all of the country at the provincial level, the Provincial Social Security Bureau responsible for remote medical staff cooperation sigh. "Wrapped just finished the" Long March "first step." The staff said, but also to accelerate the system platform interface docking and upgrading, the establishment of a complete daily liaison machine

海南异地就医结算合作区223个 报销不再“两头跑”   我省打通异地就医结算全国“大动脉”,合作统筹区达223个   异地就医结算不再“两头跑”   海南日报记者王培琳   9月13日,随着我省社保局与上海市医保中心签订了异地就医合作协议,我省异地就医结算的合作统筹区达到了223个,覆盖了全国所有的省级统筹区(不含港澳台)。这对我省的异地就医结算进程来讲,具有里程碑意义。   异地就医结算符合现代人流动性大的特点,是助力海南国际旅游岛建设的重要事项。省委、省政府高度重视这项牵动民心的工程,并将其上升为省长督办工程。今年4月21日,省长刘赐贵指出,我省要加快推动与全国各兄弟省市区的异地就医结算工作,力争在全国率先实现异地就医直接结算,并逐步推进国际异地就医结算。   异地就医结算惠民生   从沈阳退休的72岁老人曲华丽,自退休便到三亚跟随儿子儿媳一起生活,2014年突发脑血栓住院,前后花费几万元,家人却只能将医药费单据拿回沈阳才能报销。其儿媳闫雅辉通过咨询,帮助老人申请了异地就医登记,自此,老人便可在三亚的两个定点医院就医并直接进行医保结算。   “现在每次住院都可以直接进行网上结算,体会到之前奔波的辛苦,才能感受到现在异地就医结算的便捷。”说起异地就医结算,闫雅辉感触颇深。   异地就医结算合作覆盖全国所有省级统筹区,意味着海南更加开放、包容,越来越多的外省人来海南定居以及在海南工作的外省人回乡养老,将不再受医保限制。   “客观来讲,异地就医的快速推进,促使我省与合作统筹区共享医疗资源,对海南省和合作统筹区来讲,都是惠民好事,也会吸引更多的省外人来琼定居。”省社保局医保处相关负责人说。   海南是我国外来人口较多的省份,尤其是2009年海南国际旅游岛上升为国家战略,来琼定居、度假、投资的人数剧增,对此,我省制定工作计划,将尽快探索出异地就医结算新路子定位为重点督办工程,并在人力、财力上予以支持,同时,省内外广大参保人的呼声,促使我省异地就医结算在2009年就拉开帷幕,当年便与广东、广西、贵州、黑龙江、山西等5省份签订了异地就医结算合作协议。   探索结算方式多样化   说起与全国所有省级统筹区达成合作协议,省社保局负责异地就医合作的工作人员感叹不已。“签订完协议只是完成了‘万里长征’第一步。”该工作人员表示,还要加快系统平台接口对接和升级改造,建立完善日常联络机制,才能确保协议内容尽早落地。   在省委、省政府的支持下,人社部门通力协作,2009年11月,在未增加编制的情况下,省社保局抽调专职经办人员,依托医保处成立异地就医结算办公室,专门负责异地就医结算的相关具体工作;2009年底,省政府拨付专项经费360万元,用于跨省就医结算系统平台开发建设,为各经办机构与定点医院之间构建信息交流渠道,初步解决了各方信息不能共享的问题,实现了与合作的统筹区经办机构之间顺畅地办理异地就医结算业务。   2010年12月,省人社厅、财政厅制定下发《海南省基本医疗保险参保人员异地就医结算服务工作实施办法》,省社保局制定了《海南省基本医疗保险异地就医结算操作规程》,这两个规范性文件的出台为开展异地就医结算工作夯实了制度基础。   结算模式是异地就医结算工作的核心问题,不仅要符合不同统筹区的政策规定,还要操作简便可行。我省在建设异地就医结算系统平台时,充分考虑这种情况,提供了即时结算、延时结算和点对点结算3种结算模式供合作方统筹区酌情选用,增加了合作的灵活性。   截至2016年5月,我省异地就医结算服务量从2010年的41人次增至46728人次,发生医疗费用总额1.59亿元,统筹支付1.12亿元。从异地就医数据分析,外省在海南就医结算人次占总人次的93%,海南在外省就医结算人次仅占总人次的7%(主要集中在广州市和异地安置人员集中地湛江市)。   推动合作范围覆盖全国市县   我省异地就医结算合作的区域已经覆盖国内所有的省级统筹区,但是异地就医结算在全国所有市县范围内实行仍然任重而道远,目前也有部分已经签订合作协议的省市由于合作方式的争议并未有实质业务的开展。   “譬如,有些统筹区要求必须刷社保卡就医,参保人在海南就医无法做到,就难以进行结算,很多原因都有可能导致合作难落地。”省社保局医保处相关负责人表示。   目前而言,缺乏统一病种目录、药品目录、服务项目编码代码等,制约了跨省就医联网结算的推行。同时,采用就医地目录即时结算与参保人回参保地报销的金额可能有一定差异,个别参保人对此存有异议。   “并且,一些门诊和急诊花费动辄上万,希望也可以在异地就医中有一定报销。”来自沈阳、定居海口的市民郭雪琴说。   据省社保局医保处相关负责人介绍,我省将继续研究制定社保卡刷卡就医操作办法,下一步将在省内实现免登记就医,进而实现省外社保卡在我省刷卡登记、即时结算,以及个账支付门诊费用等功能,并研究实现特殊门诊跨省就医即时结算的办法。   此外,还将推进医保结算由与省一级协作向与各省市区所辖地市县级统筹区建立协作关系,逐步实现参保人在全国(大陆)任何地方都能享受医保直接结算。   同时着眼国际旅游岛建设,研究制定跨境就医结算相关政策,逐步与来琼旅游、度假、居住人数较多的国家开展医保结算工作。   (本报海口9月17日讯)相关的主题文章: