医保手工报销办理指南

2021-08-17 16:36:21 来源:北京FASCO 阅读 246
<p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">    <span style="background: white;">2021</span></span><span style="color: black; background: white;">年<span lang="EN-US">1</span>月<span lang="EN-US">1</span>日起,北京市将正式启用医保电子凭证!在北京参加城镇职工医疗保险的员工,如发生未经医保实时结算的门(急)诊及住院医疗费用,可参照以下流程申请医保手工报销。</span></span></p> <p style="margin: 0cm; margin-bottom: .0001pt; text-indent: 2.25pt; line-height: 200%; background: white;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><strong><span lang="EN-US" style="color: black;"> </span></strong></span></p> <p style="margin: 0cm; margin-bottom: .0001pt; text-indent: 2.25pt; line-height: 200%; background: white;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><strong><span lang="EN-US" style="color: black;">   </span></strong><strong><span style="color: black;">一、申请医保手工报销需符合的条件</span></strong></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">    </span><span style="color: black;">因以下原因,员工未使用社保卡就医产生的门(急)诊、住院医疗费用,可由北京<span lang="EN-US">FASCO</span>为员工向社保中心申请手工报销。</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="color: black;"><span style="mso-list: Ignore;">1.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">参保人员在定点医疗机构就医期间,因使用医保电子凭证异常或医保专用网络发生故障等客观原因,未能实时结算的医疗费用,个人全额垫付后,可通过参保单位或社保所申请医疗费用手工报销。</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="color: black;"><span style="mso-list: Ignore;">2.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">在异地医保定点医院急诊<span lang="EN-US">(</span>含急诊留观住院<span lang="EN-US">)</span>就医发生的费用。</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="color: black;"><span style="mso-list: Ignore;">3.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">已办理医疗异地就医手续,在异地指定医院就医产生的未实时结算的医疗费用。</span></span></p> <p style="margin: 0cm; margin-bottom: .0001pt; line-height: 200%; background: white;"><span lang="EN-US" style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; color: black; font-size: 12pt;"> </span></p> <p style="margin: 0cm; margin-bottom: .0001pt; line-height: 200%; background: white;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><strong><span lang="EN-US" style="color: black;">   </span></strong><strong><span style="color: black;">二、申报手工报销所需材料:</span></strong></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">  </span><span style="color: black;">(一)门(急)诊手工报销材料</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">1.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">收费单据(发票);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">2.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">药品处方(底方);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">3.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">检查、治疗费用明细(收费单据未注明收费明细的,须提供);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">4.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">急诊诊断证明;(盖有急诊章的急诊处方、盖有急诊章的北京市医疗保险专用处方、急诊诊断证明书,提供其中一项即可)</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">5.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">外伤就诊的,提供外伤情况说明;</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="color: black;"><span style="mso-list: Ignore;">6.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">参保人员在定点医疗机构就医期间,因使用医保电子凭证异常或医保专用网络发生故障等客观原因,未能实时结算的医疗费用的情况说明;</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span style="color: black;">7.</span></span><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 16px;">   </span><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 16px;"> </span><span style="background-color: #ffffff; font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 16px; text-indent: 32px;">医疗机构等级证明(非北京地区就诊需提供)。</span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">  </span><span style="color: black;">(二)住院费用手工报销材料</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">1.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">收费单据(发票);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">2.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">出院诊断证明;</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">3.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">住院费用结算单(或汇总明细清单);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">4.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">全额结算证明(异地住院费用无需提供);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="line-height: 200%; color: black;"><span style="mso-list: Ignore;">5.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">外伤就诊的,提供外伤情况说明。</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><!-- [if !supportLists]--><span lang="EN-US" style="color: black;"><span style="mso-list: Ignore;">6.<span style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; line-height: normal;">    </span></span></span><!--[endif]--><span style="color: black;">参保人员在定点医疗机构就医期间,因使用医保电子凭证异常或医保专用网络发生故障等客观原因,未能实时结算的医疗费用的情况说明(异地住院费用无需提供);</span></span></p> <p style="margin-left: 36.0pt; text-indent: -18.0pt; line-height: 200%; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span style="color: black;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span>7.</span></span>    <span style="background-color: #ffffff; text-indent: 32px;">医疗机构等级证明(非北京地区就诊需提供)。</span></span></span></p> <p style="margin: 0cm; margin-bottom: .0001pt; line-height: 200%; background: white;"><span lang="EN-US" style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; color: black; font-size: 12pt;"> </span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">   </span><span style="color: black;">温馨提示:</span></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">    1.</span><span style="color: black;">请将收费单据、明细及底方一一对应并按日期整理排序。</span></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="color: black;">    2.</span><span style="color: black;">当年度未结算的医疗费用单据须于次年<span lang="EN-US">1</span>月<span lang="EN-US">5</span>日前提交至北京<span lang="EN-US">FASCO</span>。</span></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"><span lang="EN-US" style="text-indent: -18pt;">    3.</span><span style="text-indent: -18pt;">手工报销期间,参保人员可持社保卡或医保电子凭证到定点医疗机构正常就医结算。</span></span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;">   </span></p> <p style="line-height: 200%;"><span style="font-family: 'Microsoft YaHei', 'Helvetica Neue', 'PingFang SC', sans-serif; font-size: 12pt;"> 北京FASCO社保经办人联系电话:<span lang="EN-US">010-64661073</span>;联系邮箱<span class="MsoHyperlink"><span lang="EN-US"><a href="mailto:shebao@fasco.com.cn">shebao@fasco.com.cn</a></span></span>。</span></p> <p class="MsoNormal"> </p>

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