1. Provincial medical insurance for employees:
1) Receiving Application Form: Patients applying for chronic special diseases in the province directly go to the Medical Insurance Office to receive the Application Form for Identification (Re-examination) of Chronic Special Diseases in Outpatients of Provincial Insured Persons;
Venue: Jixi Road Campus: Internal Medical Technology Building 1 Floor Medical Insurance Office or "one-stop" service desk of outpatient service; High-tech campus: medical insurance window at the toll booth on the first floor of inpatient department.
2) Fill in the application form: the insured must accurately fill in the applied disease type, and ask the doctor with disease identification qualification to fill in the identification conclusion according to the name of the applied disease type, and sign and seal it at the same time. (See the application form for the name of the specific disease and the identification doctor)
3) Submission materials: When the insured handles chronic diseases and special diseases in the outpatient department, he should provide his social security card, signed and sealed application form, outpatient medical records, discharge records, operation records, inspection reports meeting the appraisal standards and other relevant certification materials.
4) The application takes effect: 3-5 working days after the application materials are submitted, the outpatient special disease treatment will be paid.
4) Disease reexamination: If chronic or special diseases need further treatment after the treatment period expires, please apply for reexamination in time.
5) Change the designated point: the designated medical institutions for chronic diseases and special diseases can be changed 1 time a year. (Please go to the medical institution to be changed)
2. Hefei medical insurance:
1) The identification of chronic diseases and special diseases in employees' medical insurance outpatient service is in Hefei Human Resources and Social Security Service Center (address: No.88, Government Affairs Ring Road, Hefei).
2) Identification of chronic diseases and special diseases in residents' medical insurance outpatient service is on the third floor of Hefei Labor Bureau (address: intersection of Jinzhai Road and Lujiang Road, Hefei).
3) Tel: 055 1- 12345.
4) Effective application: After receiving the notice approved by Hefei Social Security Bureau, you can enjoy outpatient treatment for chronic diseases and special diseases.
3. Medical insurance in different places: applications for chronic diseases and special diseases in outpatient clinics are handled in the medical insurance center of the insured place. Please consult the medical insurance center of the insured area for the process and application materials. Patients with chronic diseases in different places who plan to settle their chronic diseases in our hospital need to go through resettlement or referral procedures in the medical insurance center of the insured place, and they can settle directly by presenting their social security cards (or electronic social security vouchers) and medical cards at the cashier's office of our hospital.
Second, the doctor's instructions and precautions
1. Association registration ("card binding"): for the first visit after enjoying the treatment, the association between the social security card and the hospital visit card should be registered at the outpatient cashier (it only needs to be associated once for the first time, and the unrelated visit card cannot be settled according to the chronic diseases and special diseases in the outpatient clinic).
2. Take the initiative to inform: When seeing a doctor or settling accounts, please take the initiative to inform the staff of the types of chronic diseases and special diseases they enjoy.
3. Drug list: The list of medical insurance drugs in the province and Hefei can be found on the website of Anhui Medical Insurance Bureau or the official WeChat account "Medical Insurance Tips".
4. Reimbursement policy: employees' medical insurance (including provincial and Hefei employees' medical insurance) will begin to enjoy reimbursement payment after the medical expenses reach the deductible line (cumulative 600 yuan) in a natural year, and Hefei residents' medical insurance will begin to enjoy reimbursement payment after the medical expenses reach the deductible line (cumulative 1 1,000 yuan) in a natural year; The calculation method of reimbursement is: the total medical expenses minus (self-funded, policy-paid items and annual unpaid deductible) and then multiplied by the reimbursement ratio. Employee reimbursement ratio: 90% in service and 95% in retirement. Resident reimbursement ratio: 75%; The upper limit of annual reimbursement varies according to the diseases applied for.
5. Precautions: 1) Patients with special diseases cannot be reimbursed for outpatient expenses at the same time during hospitalization; 2) The medical expenses unrelated to the enjoyment of the disease and the expenses of the overmedication list cannot be reimbursed; 3) If patients in different places have questions about the settlement amount and reimbursement scope of medical insurance, please consult the medical insurance center of the insured place.