医保手工报销办理指南

<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;">7.</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">010-64661074</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>