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商业保险出院可“秒赔”

2017-08-18 06:32:28   中国青年网

本报讯(通讯员孟佳 记者胡楠)随着居民保险意识的提升,商业医疗保险的投保率正在以惊人速度增长。然而,绝大多数商业医保采用的事后报销式理赔流程,一定程度上影响了患者的就医体验。近日,记者从武汉市中心医院获悉,该院与信诚人寿达成战略合作协议,正式上线信诚人寿商保在线直赔系统,今后,投保商业医保的患者不用四处奔波,出院即可实时办理商保结算,现场获得理赔。

在过去,商业医保理赔需要被保险人提交资料、等待保险公司受理、审核、放款,周期多在3到30天不等。报销时除需提供基本身份资料,还要出具医院盖章的病历、费用清单、化验单、收据等一大摞资料。

“制约商业医保报销流程的主要原因之一,就是医院与保险公司的信息系统彼此隔绝。”据信诚人寿副总经理李海介绍,本次信诚人寿与武汉市中心医院、默联融医付联手,将医院、保险公司等信息联结在一起,实现保险公司与医院信息系统的无缝对接,被保险人的住院信息可以及时传输至保险公司理赔系统,后台实时理算,成功突破传统流程中滞后赔付的桎梏,为客户提供即时支付的快速服务体验。

“通过为患者提供商保直赔服务,实现住院费用的一站式结算,不仅提升了老百姓的就医体验,也提高了医院的工作和管理效率。”武汉市中心医院副院长冯革奇表示。

此外,针对市面现有商业医疗保险产品“重收益、轻医疗”的现状,信诚人寿已推出“小雨伞”医疗保险。作为基本社保的有效补充,该险种不设免赔额,理赔范围涵盖住院费用及住院前后门诊费用,报销药品范围也较基本医保目录更为宽泛。

价格方面,“小雨伞”投保门槛亲民,最低年保费不到300元。以30岁男性为例,投保信诚“小雨伞”医疗保险A款5份,年缴保费1234.6元(首次投保),可享受最高2.5万元的医疗保障。

据信诚人寿副总经理李海介绍,之所以选择武汉市中心医院作为首家直赔合作医疗机构,是由于在商业医保客户中,武汉市中心医院住院人数最多,其次是湖北省人民医院、华中科技大学同济医学院附属协和医院。

根据服务规划,未来信诚人寿直赔新服务将逐步推广至更多医院,打造以武汉市中心医院为代表的湖北模式,覆盖省内90%以上二甲及以上医院,进一步,湖北模式还将在全国复制推广,惠及信诚人寿所有的客户。

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