Notice of the Office of the State Administration of Medical Security on the direct settlement of general outpatient expenses across provinces in The Beijing-Tianjin-Hebei, Yangtze River Delta and Southwest Provinces

Notice of the Office of the State Health Insurance Administration on the Direct Settlement Of General Outpatient Expenses Across Provinces of Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang, Anhui, Chongqing, Sichuan, Guizhou, Yunnan, Tibet and other provinces, autonomous regions and municipalities directly under the Central Government of China: For We will carry out the spirit of the Fourth and Fifth Plenary Sessions of the 19th Central Committee of the Communist Party of China, speed up the implementation of the settlement system for off-site medical treatment, steadily and orderly promote the pilot work of direct settlement of outpatient expenses across provinces, comprehensively consider the actual situation of cross-regional business in the early period, and decide to connect 12 pilot inter-provincial general outpatient expenses inter-provincial direct settlement services, such as Beijing-Tianjin-Hebei, Yangtze River Delta and five provinces in the southwest.
The relevant matters are heeded as follows: First, the scope of Unicom services in Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang, Anhui, Chongqing, Sichuan, Yunnan, Tibet and other 11 provinces (regions, cities) of the overall area, as well as Guizhou Province and the southwestern Bui Hmong Autonomous Prefecture all access to the national off-site medical settlement system and connect general outpatient expenses cross-provincial direct settlement services.
, 102,000 cross-provincial direct settlement fixed-point medical institutions and 118,000 fixed-point pharmacies were opened, the specific information can be queried through the national health insurance service platform APP.
, to do a good job before Unicom's preparatory work in accordance with the "National Medical Security Administration Office on the outpatient expenses cross-provincial direct settlement business to detect problems found in the notice" requirements, to make urgent rectification.
While ensuring the smooth flow of the settlement system, continue to organize the first pilot inter-provincial cross-testing work, giving priority to ensuring cross-provincial direct settlement business between the concentration of medical treatment and the large outflow of insured persons, and ensuring that cross-provincial direct settlement business can be successfully handled through medical insurance electronic vouchers and social security cards; To carry out relevant training on the medical institutions of the direct settlement of general outpatient expenses across provinces to ensure that the window settlement personnel are familiar with and able to operate the relevant business; Open the contact channels of fixed-point medical institutions and agencies to ensure that the settlement failure and other problems are resolved in the first place.
, do a good job during the trial run of the operation monitoring from February 1, 2021 to start the trial run.
relevant provincial medical security departments should organize the overall areas under their jurisdiction to do a good job in operational monitoring and system security.
focus on tracking the relatively concentrated settlement of general outpatient expenses of fixed-point pharmaceutical institutions, do a good job in the policy publicity and interpretation of the insured masses, make good work plans, timely response and handling of system failures and settlement details.
4. The work requirements should be attached great importance to strengthening organizational leadership, establishing and perfecting the mechanism of business coordination, arranging for special people to track the implementation of direct settlement of general outpatient expenses across provinces, and timely feedback to the National Health Insurance Bureau in the event of major problems.
office of the National Health Insurance Administration on January 14, 2021