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广西参保人员实现31省份住院费用直接结算

2017-08-10 15:10:29   中国青年网

新华社南宁8月10日电(卢羡婷、俸夕惠)今年以来,广西全面推进全国医保联网和跨省异地就医住院直接结算工作。目前,广西14个地级市和自治区本级共285家定点医疗机构开通了跨省异地就医直接结算,覆盖所有区县;广西参保人员在31个省份住院费用可直接结算。

近日,广西河池市参保人员王女士到北京探亲途中突发脑梗,在北京中医药大学东方医院急诊治疗,并及时向河池市社保局报备。8月2日,王女士办理出院手续时,持社会保障卡,在医院直接刷卡,完成住院费用即时结算,成为广西在北京跨省异地就医直接结算第一人。直接结算住院医疗费用13509.57元,支付个人自付部分2273.92元。

目前,全国31个省份和新疆生产建设兵团均已接入国家异地就医结算系统。广西参保人员只要持有新的社会保障卡,并办理异地就医备案登记手续,就可在已开通全国异地就医直接结算的医院,直接办理住院费用结算。

截至8月5日,广西参保人员到外省就医已结算41人次,覆盖异地安置、异地居住、异地工作、转院转诊、异地急诊5类人群,其中退休异地安置、异地居住人员结算27人次,占66%,是跨省异地就医需求最多人群,也是跨省直接结算重点解决的人群。作为就医地,广西已为外省参保人结算29人次,服务延伸到县级定点医疗机构。

为让参保人员更好地享受异地就医直接结算服务,广西进一步优化基本医疗保险异地就医服务流程。异地安置退休、长期异地居住、常驻异地工作人员均可在参保地社保局办理异地就医备案登记;异地急诊人员在入院后5个工作日内,通过传真、邮件等方式把就诊医疗机构出具的入院记录发送至参保地社保局就可备案;异地转诊人员凭具有转诊资格的定点医疗机构出具的转诊审核表,就可到参保地社保局办理备案。

2015年以来,广西大力推进社会保障“一卡通”。截至6月底,“一卡通”服务范围涵盖门诊、住院、转诊、门诊慢性病、药店购药等项目,覆盖至乡镇(社区)卫生院,全区互联互通的定点医院2335家、定点药店4279家;结算205.11万人次,结算金额19.79亿元。

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