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九月底 跨省异地就医住院医疗费用将实现直接结算

2017-09-01 05:00:52   中国青年网

“外地人在海南住院能和本地人一样刷社保卡结算,免除了跑腿之苦、省去了垫付之烦,太方便了。”今年1月17日,来自吉林的李艳在解放军总医院海南分院办理出院手续,通过国家异地就医结算平台,她只花了几分钟就完成医疗费用即时结算。这是国家跨省异地就医结算平台上线运行后,全国首位通过该平台实现跨省异地就医即时结算的医保参保人。

到今年9月底实现跨省异地就医住院医疗费用直接结算,是我国政府对异地就医参保患者的一个郑重承诺。记者近日从人力资源和社会保障部获悉,目前,全国所有省级异地就医结算系统、所有统筹地区均已与国家异地就医结算系统对接。接下来,异地就医人员将彻底告别原来动辄数十天的就医费用跑腿报销,实现持社保卡出院时直接结算。

异地住院就医 出院直接报销

如今,越来越多的老人退休后随子女到异地居住,参保地与就医地不在同一地点。这些异地居住的老人住院看病,需要拿着收费单据等回医保参保地报销,手续烦琐不说,还经常因为单据不全、缺少凭证等原因来回奔波。

“以前的异地结算流程非常烦琐。”李艳说,此前退休人员回老家后,先填一份“退休人员异地安置”表格,再选定三家医院,住院时要住到指定医院。如需办理异地就医结算,还需要拿着病历、诊断建议书、住院证明、费用明细和报销单据回老家结算,整个报销时间在1至2个月左右。“在异地居住超过1年以上的,还需要在居住地补写1份居住证明,非常麻烦。”

而在统筹地区实现结算系统联网后,结算不再这么麻烦了。只要在定点联网医院支付自费的部分,报销部分持社保卡直接结算,直接节省近两个月的时间。

“以前异地就医费用手工报销,需要患者在出院后先等着复印病历,集齐各种发票单据,接着到参保地医保经办机构进行手工录入和审核。”一位医保经办机构工作人员告诉记者,“对于医保经办机构来说,每张单据都要手工录入,工作量很大,导致参保人出院几个月才能领到报销费用。现在,只要符合条件,参保人提前备案,可以用社保卡实现直接结算,既可减轻医保经办机构经办负担,又能通过数据网络传输,杜绝假发票的问题。”

数据多跑路 患者少跑腿

目前,哪些参保人群可以申请跨省异地就医直接结算?根据此前人社部、财政部出台的《关于做好基本医疗保险跨省异地就医住院医疗费用直接结算的通知》,申请人群包括:参加基本医疗保险的异地安置退休人员、异地长期居住人员、常驻异地工作人员,及符合参保地转诊规定的参保人员。参保人员在跨省异地就医前,需单位医保专管员、本人或被委托人按规定到医保经办机构进行登记备案。医保经办机构将异地就医信息逐级上传,形成全国异地就医备案人员库,供就医地经办机构和定点医疗机构获取异地就医参保人员信息。录入备案信息后,参保人员便能在本人备案、已开通跨省异地就医住院医疗费用直接结算的异地定点医疗机构实现直接结算。

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