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4类人跨省异地就医直接结算 次均用时仅10秒

2017-09-27 02:40:42   新京报

“从目前已结算人员的结构分析,异地安置退休人员占39%,异地长期居住人员占10.3%,常驻异地的工作人员(如驻外办事处等,或在外地急诊就医)达1.6%,异地转诊人员占49.1%。”唐霁松说。

释疑2:跨省直结有哪些流程?

患者跨省异地就医,需要“先备案、选定点、持卡就医”

从流程和环节来看,人社部社会保险事业管理中心副主任黄华波介绍,突出信息惠民和“放管服”的要求,为了让信息多跑路、群众少跑腿,这个工程绝大部分环节和流程都不需要直接和群众见面,通过两个途径结算:一是通过国家结算系统自动完成,二是国家各级经办机构之间后台来操作完成。群众需要参与和重点把握的环节有哪些?就是三句话、十个字:“先备案、选定点、持卡就医”。

“先备案”要求参保人员跨省就医前,需在参保地的经办机构进行备案。黄华波说,经办机构采集必要的信息,目前全国有统一的备案表,进行了明确,关键的信息是两条。一是要说清楚备案的原因是什么,你是出去常驻、异地安置、在外工作,还是转诊转院,要把原因告诉经办机构。二是要去什么地方,是去北京还是去海南。经办机构采集这两个关键信息后,传到国家的结算系统、相关的地区和医疗机构,其他的信息社保卡都有,比如姓名、卡号不需要另外采集。

“选定点”就是选择异地就医的医院。黄华波介绍,比如选择去北京、上海看病,要到这些地方的跨省异地就医的定点医疗机构去。现在88%的三级医疗机构都在网上,有10个省份,所有的三级医疗机构都是跨省的定点机构。其中,北京市率先实现了所有有床位的医院,包括一级、二级、三级,都是跨省的定点医疗机构,达到了676家。上海也实现了所有的三级、二级医院有床位的全部联网。参保人员到外地可以选择的医疗机构范围越来越大。

释疑3:跨省就医社保卡咋用?

患者一定要用社会保障卡,要持卡办理入院和结算

人社部社会保险事业管理中心副主任黄华波提醒,患者一定要用社会保障卡,要持卡办理入院和结算。

“去北京的一些医院发现,有些患者在入院时没有持卡,医院误认为这个患者是自费人员,就办理了全自费住院,出院时就很难转为跨省直接结算的病人。”黄华波说,我们看了医院记录,医保病人是24个,其中医保病人能够直接结算的是8个,所以提醒医保患者,“有社保卡的要尽可能持卡入院”。

社保卡全称是“中华人民共和国社会保障卡”,人社部信息中心副主任宋京燕介绍,它是异地就医身份识别和直接结算的唯一凭证,这个唯一凭证包括两大核心功能:一是身份凭证,二是结算工具。

“也就是说,患者在参保地完成异地就医备案手续之后,到就医地医院看病时,只需要携带这张社会保障卡,拿着卡就可以完成本人的身份识别、参保地的判断,直接办理入院登记和出院结算。”

责任编辑:穆启春 CN063
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