Notice on the issuance of the "Guangzhou Urban Resident Basic Medical Insurance

Implementation Rules"

Suilao Social Medicine [2008] No. 7

< p>All district and county-level municipal labor and social security bureaus, and all relevant units:

This bureau is based on Article 22 of the "Guangzhou Municipal Basic Medical Insurance Trial Measures for Urban Residents" (Suifu Ban [2008] No. 22) According to the authorization regulations, the "Guangzhou Urban Resident Basic Medical Insurance Implementation Rules" were formulated. It is now issued to you, please comply with it.

Guangzhou Municipal Labor and Social Security Bureau

July 18, 2008

(Office: Medical Insurance Department, contact number: 83330864)

Guangzhou Urban Resident Basic Medical Insurance Implementation Rules

According to the "Guangzhou Urban Resident Basic Medical Insurance Trial Measures" (Suifu Ban [2008] No. 22, hereinafter referred to as " Trial Measures") and formulate these implementation rules.

1. Insurance registration and payment

(1) Handling of insurance registration business

The labor and social security, civil affairs, Disabled Persons' Federation and education departments in each district, According to the residential distribution of residents, insurance registration points will be set up in each sub-district (town) labor and social security service center, civil affairs office, Disabled Persons' Federation department, child care institutions, schools and other institutions within the jurisdiction. Urban residents (hereinafter referred to as "residents") within the municipality's medical insurance coordination area (including the administrative jurisdiction of Yuexiu District, Haizhu District, Liwan District, Tianhe District, Baiyun District, Huangpu District, Nansha District, and Luogang District) shall be treated as follows: To handle insurance registration procedures:

Minors with urban household registration in this city (referring to residents under the age of 18 before June 1 of the current year), non-employed residents, and elderly residents can choose to go to the insurance company by themselves or their agents. Any street (town) labor and social security service center in this city handles insurance registration procedures;

Students with formal enrollment in various schools in this city, and minors with urban household registration in this city who are enrolled in child care institutions, respectively The insurance registration procedures shall be handled uniformly by the schools and daycare institutions where they are located;

Among the above-mentioned residents, those who are subject to the city’s minimum living allowance, persons from low-income families with difficulties, and government dependents accommodated by social welfare institutions shall go to their respective streets to The (town) Social Affairs (Civil Affairs) Office handles insurance registration procedures.

Severely disabled persons in this city should go to the relevant street (town) Disabled Persons’ Federation department to complete the insurance registration procedures.

(2) Insurance registration information

1. Insured residents must fill out the "Guangzhou Urban Resident Basic Medical Insurance Participation Application Form" and apply for insurance registration with the following information:< /p>

(1) Non-employed residents, elderly residents and full-time students studying in various colleges and universities, secondary vocational and technical schools and technical schools should provide the original and photocopy of their household registration book and ID card (photocopy of the household registration book) The documents include the first page of the household name and the current page of the insured person, the same below);

(2) Minors and students studying full-time in primary and secondary schools should provide the original and copy of the household registration book, including those after birth. Newborns under three months old should provide the original and photocopy of their "Birth Certificate";

(3) Foreign students should provide the original and photocopy of their passport when applying for insurance;

< p>2. If the insured person chooses to entrust a bank transfer to pay the resident medical insurance premium, he must provide the designated bank passbook and a copy, the original and copy of the ID card of the owner of the passbook, fill in and sign the "Entrusted Bank Automatic Transfer Payment" in the prescribed format. Authorization letter for payment of social insurance premiums. Registered insured persons who have not gone through the automatic transfer payment procedures of the entrusted bank shall go to the municipal local taxation department to entrust the collection bank branch to pay.

3. In addition to providing the above information, the following residents also need to provide corresponding information:

(1) People from low-income families with difficulties must provide the "Guangzhou Low-income and Needy Families Certificate" ;

(2) Those who are eligible for urban minimum living security must provide the "Guangzhou Urban Resident Minimum Living Security Fund Receipt Certificate";

(3) Those who are eligible for rural minimum living security must provide Provide the "Guangzhou Rural Residents Minimum Living Security Fund Receipt Certificate";

(4) Persons with severe disabilities need to provide the "Disability Certificate".

(3) Collection and review of residents’ personal information

Each street (town) labor and security service center is responsible for minors, non-employed residents, and elderly residents, and childcare institutions are responsible for their For children entering day care, the school is responsible for collecting and checking the personal insurance information of the students in school, and sends the insurance registration information to the district social insurance fund management center for review every week; the district social insurance fund management center will work within 10 days after receiving the information. The "Guangzhou Urban Resident Basic Medical Insurance Individual Collection Verification Form" (hereinafter referred to as the "Verification Form") will be reviewed and printed within the day, and then distributed to the insured persons by the above-mentioned insurance registration agency.

Each street (town) civil affairs department is responsible for the collection, verification and preliminary review of the personal information of registered insured persons, and submits it to the district civil affairs bureau for review before the 20th of each month; the district civil affairs bureau will review it before the 23rd of each month The results of individual financial aid qualifications of the insured person are sent to the district social insurance fund management center; the district social insurance fund management center will review and print the "Approval Form" within 10 working days after receiving the information, and then distribute it to the civil affairs department of each street (town) The "Approval Form" is given to the insured persons.

Each street (town) Disabled Persons' Federation department is responsible for the collection and verification of insurance information for severely disabled persons. After preliminary review of the individual financial aid qualifications of the insured, it shall be submitted to the district Disabled Persons' Federation department for review before the 15th of each month; the district Disabled Persons' Federation The department will review and summarize the results before the 20th of each month and submit them to the district civil affairs bureau. The district civil affairs bureau will send the results of the review of the individual financial aid qualifications of the insured to the district social insurance fund management center before the 23rd of each month; the district social insurance fund management center will receive the information after receiving the information. The "Approval Form" will be reviewed and printed within 10 working days, and then the "Approval Form" will be distributed by each sub-district (town) Disabled Persons' Federation department to its insured persons.

For insured persons whose insurance registration is not accepted and who fail the review, each insurance registration department shall issue a notice of refusal to participate in resident medical insurance.

Residents whose family members are responsible for overall medical care managed by provincial, municipal, and district public medical management departments are not insured for the time being.

All insurance registration agencies will suspend accepting insurance registration business on the last two working days of each month.

(4) Starting and ending time of the insurance year

Resident basic medical insurance premiums are collected annually. An insurance year is from July 1st of the current year to June 30th of the following year.

After residents register for insurance, they establish a medical insurance relationship, which is valid within the insurance year.

(5) Collection of insurance premiums

The local taxation department entrusts banks to collect premiums for basic medical insurance. The specific collection business shall be clarified by signing a collection agreement between the local tax department and the bank.

(6) Payment method and payment period

Residents who have registered for insurance shall pay the fee to the collection unit entrusted by the local tax department within the specified period with the "Approval Form". Among them, residents who participate in the insurance for the first time will pay their premiums from the 3rd to the 23rd of the month following the insurance registration, and residents who continue to participate in the insurance in the new year will pay their premiums from June 3rd to the 23rd of each year.

Those who are funded by the social medical assistance fund and pay the insurance premium shall be subject to the Civil Affairs Bureau’s review and confirmation of the subsidy objects and the amount of the social medical assistance fund that should be funded.

(7) Collection of residents’ basic medical insurance premiums

The residents’ basic medical insurance premiums collected by the local taxation department shall be transferred in full to the special financial account of the residents’ basic medical insurance fund in that month. It also conducts regular reconciliations with the Municipal Social Insurance Fund Management Center (hereinafter referred to as the Municipal Fund Center), the Municipal Medical Insurance Service Management Center (hereinafter referred to as the Municipal Medical Insurance Center), and the Municipal Finance Bureau.

The Municipal Fund Center will send the social medical assistance fund subsidy data report to the Municipal Civil Affairs Bureau before the 10th of each month. The Civil Affairs Bureau will review and confirm the report and send it to the Municipal Medical Insurance Center before the 20th of the month.

The Municipal Fund Center shall determine the amount of government funding that governments at all levels should pay to insured persons and social medical assistance fund recipients whose individual contributions have been paid, and send it to the Municipal Medical Insurance Center. The Municipal Medical Insurance Center summarizes the amount of funding required by governments at all levels and the amount of social medical assistance funds that should be funded on a monthly basis, and applies for funding from the Municipal Finance Bureau, which is settled annually.

The Municipal Finance Bureau will uniformly transfer the funds that should be funded by governments at all levels and social medical assistance funds into the special financial account of the Resident Basic Medical Insurance Fund. The Civil Affairs Bureau, Municipal Medical Insurance Center and Municipal Finance Bureau conduct regular reconciliations.

2. Changes in insurance coverage and information

(8) Renewal procedures

Those who have participated in the resident medical insurance do not need to renew their insurance in the new year. After completing the insurance registration procedures and paying the basic medical insurance premiums for urban residents as required, the residents’ medical insurance benefits will be automatically extended.

(9) Insurance suspension procedures

If the resident medical insurance relationship needs to be terminated, the insured person (guardian) must fill in the "Urban Resident Basic Medical Insurance Insurance Cessation Registration Form" and submit it to Before the end of May of that year, go through the insurance suspension procedures with the affiliated insurance registration department.

If the insured person fails to declare the suspension of insurance before the end of May of that year, and does not pay the premium in the new year, the insurance will be automatically suspended after the end of the new year.

(10) Processing of information changes

If the insured’s name, ID card number, household registration, personal identity and other basic information need to be changed, the "Guangzhou Urban Resident Basic Information Form" needs to be filled in. "Medical Insurance Personal Data Change Form" and return to the original insurance registration department to complete the change procedures.

In the event that insured children, such as children in day care or school, leave kindergarten, graduate, transfer to another school, or enroll in the new year, they will continue to participate in the resident medical insurance in the new year. If the basic information needs to be changed, the day care institution or school will Go to the social insurance fund center in your district to go through the change procedures.

3. Insurance Certificate Management

(11) Management of Social Medical Insurance Card

Guangzhou Urban Resident Medical Insurance Card (hereinafter referred to as "Resident Medical Insurance Card" ") serves as a voucher for insured persons to seek medical treatment and handle medical insurance-related business, and is managed uniformly by the Municipal Medical Insurance Center. The resident medical insurance card is processed according to the issuance method of Guangzhou urban employee medical insurance card.

The resident medical insurance card also has the financial functions of an ordinary savings card.

The sub-district (town) labor and social security service agencies, daycare institutions, schools, district civil affairs departments, and district Disabled Persons’ Federations shall hold the relevant information to the application after the 19th of the month following the first registration of the insured person. The medical insurance agency in the local area will collect the resident medical insurance card and distribute the medical insurance card to the insured persons who have paid for the month before the end of the month.

(12) Use of social medical insurance card

The resident medical insurance card can only be used by the insured person and cannot be lent to others. Medical expenses incurred due to illegal use will be borne by the insured after verification. The insured person shall bear the responsibility himself.

During the period when the resident medical insurance card is lost or reproduced, the resident medical insurance card shall be replaced with a certificate of loss report or a receipt for the replacement of the card.

(13) The effectiveness of insurance certificates

Insured persons must present valid medical insurance certificates and valid identity documents when seeking medical treatment at designated medical institutions; Before the voucher is issued, all medical expenses incurred for medical treatment shall be borne by the insured.

If the insured person is admitted to the hospital in an emergency or is unable to present the medical insurance certificate on the spot due to coma or other unconscious conditions, his relatives should apply for a replacement certificate within three working days of the admission.

When the insured person registers for hospitalization due to the birth and termination of pregnancy that complies with the family planning policy, he must also present the original valid certificate approved by the family planning department.

IV. Medical Treatment Management

(14) Management and use of "Resident Medical Insurance Outpatient Medical Records" and "Off-site Medical Treatment Record Book"

Unified by the Municipal Medical Insurance Center Print the "Guangzhou Social Medical Insurance Outpatient Medical Record" (referred to as "Resident Medical Insurance Outpatient Medical Record") and the "Guangzhou Social Medical Insurance Outpatient Medical Record Book" (referred to as "Offsite Medical Treatment Record Book"), and the insured will receive medical treatment at designated points in this city. When seeking medical treatment in an institution, purchase it at the price specified by the price department and keep it yourself. The specific usage methods will be stipulated separately by the Municipal Medical Insurance Center.

(15) Medical management of inpatient and outpatient special items and designated chronic disease outpatient clinics

Resident medical insurance insured persons are hospitalized, outpatient special items and designated chronic diseases in designated medical institutions in this city The medical management of treatment shall be implemented in accordance with the relevant provisions of the city’s employee medical insurance system.

(16) Ordinary outpatient (emergency) outpatient medical treatment management

General outpatient (emergency) outpatient clinics refer to outpatient (emergency) outpatient medical treatment outside specific outpatient services and designated chronic disease outpatient clinics.

Among the social insurance designated medical institutions that can use the city’s medical insurance information system to record outpatient (emergency) outpatient fees, school students and minors should choose a community health service agency (secondary or third-level (Except for community medical institutions set up in this department, the same below) or the medical institution of the school where the medical institution is located and one other medical institution, elderly residents choose a community health service institution as the selected medical institution for their outpatient (emergency) medical treatment.

School students and minors can enjoy prescribed treatment when they go to designated hospitals for outpatient (emergency) treatment of corresponding specialized diseases. The specific designated hospitals and specialties will be announced separately by the Municipal Medical Insurance Center.

In each social security year, the insured person shall go through the procedures to confirm the selected medical institution when he or she plans to go to the selected medical institution for general outpatient (emergency) medical treatment for the first time. The insured person or his guardian fills out the "Registration Form for Selected Medical Institutions for General Outpatient (Emergency) Clinics" in the "Resident Medical Insurance Outpatient Medical Record" and pastes a recent one-inch color photo of the front face without a hat; after the medical institution verifies the insured person's information, the medical institution will A special label is affixed to the corner; the insured person’s medical institution will be confirmed as the chosen medical institution for that year after the insured person’s account is settled.

After the selected medical institution is confirmed, no changes will be made within the current year. However, if the insured person has certain circumstances such as household registration transfer or change of qualifications of designated medical institutions, as well as minors and school students transferring to another school, they can go to the offices of the Municipal Medical Insurance Center to go through the procedures for changing the selected medical institution.

(17) Management of medical treatment in other places

1. Insured persons may enjoy the corresponding residents’ basic medical insurance benefits in accordance with the provisions of the "Trial Measures" if they seek medical treatment in other places as follows:

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(1) Insured persons who have lived in the same different place within the country for more than half a year and have gone through long-term medical treatment procedures in other places select medical institutions for hospitalization, specific outpatient services and designated chronic disease treatment in other places;

< p>(2) Transferred to public medical institutions outside the city for hospitalization with approval;

(3) Emergency hospitalization in other places or emergency observation;

(4) At school Students who return to their place of residence during winter and summer vacations or leave school due to illness, or who are hospitalized in local public medical institutions, outpatient for specific projects, designated chronic disease treatment, or emergency during their internship abroad.

The Resident Medical Insurance Fund will not pay for medical expenses incurred for medical treatment in other places that do not fall within the above scope.

2. The management of residents’ medical insurance for medical treatment in other places shall be implemented with reference to the relevant provisions of the city’s basic medical insurance for urban employees.

For insured persons who have lived in the same different place within the country for more than half a year, they must go through long-term medical treatment procedures in different places according to the management of long-term medical treatment in other places, and use the "Record Book of Medical Treatment in Other Places" to standardize the recording of medical information in different places.

In other circumstances, medical treatment in other places will be managed as temporary medical treatment in other places.

V. Resident Medical Insurance Benefits

(18) Benefit Scope and Standards

The scope and standards of resident medical insurance benefits shall be in accordance with the relevant provisions of the "Trial Measures" implement.

The basic medical expenses incurred by elderly resident insured persons in the outpatient (emergency) clinics of their chosen medical institutions will be reimbursed at 50%;

School students and For minors, 70% of basic outpatient (emergency) medical expenses incurred by minors in the community medical institutions or school medical institutions they choose will be reimbursed at the rate of 70%. The basic outpatient (emergency) medical expenses incurred by specialists for medical treatment shall be reimbursed at a rate of 40%; If the payment is made, the insured patient shall directly settle the payment to the designated medical institution; if the payment is due from the resident medical insurance fund, the designated medical institution shall record the account first and then report the settlement to the Municipal Medical Insurance Center on a monthly basis.

The Resident Medical Insurance Fund will not pay for ordinary outpatient (emergency) medical expenses incurred by the insured at non-selected medical institutions or non-designated hospitals and specialists. However, basic outpatient medical expenses for emergency treatment at public medical institutions in other places during the winter and summer vacations, or when students are on leave due to illness, or during internships in other places, will be reimbursed sporadically by the Resident Medical Insurance Fund at a payment ratio of 40%.

(19) Benefit transition across insurance types

If urban residents switch to urban flexible employment medical insurance during the period of participating in resident medical insurance, within the paid resident medical insurance year , months during the waiting period for flexible employment medical insurance, you can continue to enjoy residents’ medical insurance benefits.

The cumulative maximum payment limit for (twenty) years

In a social security year, if a resident changes the type of social medical insurance he or she participates in as his status changes, the amount of medical treatment that occurs during the period of participating in different types of insurance will be Fees are accumulated separately and the annual maximum payment limit is calculated separately.

(21) Payment years

The years of participation and payment for urban residents participating in the residents’ medical insurance do not add up to the years of participation and payment for the city’s basic medical insurance for employees.

6. Fund Payment

(22) Fund Payment Scope and Standards

The scope of the resident medical insurance fund’s payment of medical expenses for insured persons shall be in accordance with this The relevant provisions on the drug catalog, diagnosis and treatment items, scope of medical service facilities and payment standards of the municipal basic medical insurance for urban employees shall be implemented.

Hospital medical expenses for childbirth or pregnancy termination that comply with the family planning policy shall be implemented in accordance with the scope of medical expense payment items and catalogs of enterprise employee maternity insurance in this city and the standards stipulated in the "Trial Measures".

(23) Situations in which the fund will not pay

If one of the following circumstances occurs, the resident medical insurance fund will not pay the relevant medical expenses:

< p>1. Seeking medical treatment in medical institutions other than designated social insurance medical institutions in Guangzhou without approval;

2. Suicide or self-mutilation (except for mental illness);

3. Fights, alcoholism, drug abuse, and other injuries and illnesses caused by crimes or violations of the "Public Security Administration Punishment Law";

4. Traffic accidents, accidents, and medical accidents where it is clear that another party has assumed liability for medical expenses. Or it is clear that medical expenses paid by work-related injury insurance;

5. Seeking medical treatment abroad or in Hong Kong, Macao Special Administrative Region and Taiwan;

6. Not stipulated by the country, province, or city Other circumstances under which payment is due.

7. Management of designated medical institutions and settlement of medical expenses

(24) Management of designated medical institutions

The management of designated medical institutions for residents’ medical insurance shall be in accordance with The relevant provisions of the basic medical insurance system for urban employees in this city are implemented, and the municipal medical insurance center signs supplementary agreements with each designated medical institution.

(25) Medical Expense Settlement

The basic medical expenses incurred by the insured for hospitalization, outpatient treatment of specific items and designated chronic diseases shall be calculated according to the corresponding rates of the urban employee basic medical insurance in this city. Settlement method Settlement.

The basic medical expenses incurred by insured persons such as school students and minors who are hospitalized in designated medical institutions in this city in accordance with regulations shall be settled according to service items.

The general outpatient (emergency) medical expenses incurred by school students, minors and elderly residents in accordance with the regulations are paid by the medical insurance fund. The hospital will keep accounts in advance, and the municipal medical insurance center and designated medical institutions will Institutions settle accounts based on service items, "annual per capita limit" or "monthly average limit". The specific method is determined in the medical service agreement.

(26) Traceability of residents’ medical insurance benefits

The scope of traceability of residents’ medical insurance benefits:

Newborns within 3 months after birth (inclusive) 3 months) who participates in and pays the resident medical insurance premium for the year of birth, the basic medical expenses incurred from the time of birth to the month of payment;

School students must participate in the insurance and pay the premium before October 31 of the same year , the basic medical expenses incurred from July 1 of that year to the month of payment;

Those who participate in insurance and pay premiums within 3 months after the implementation of the "Trial Measures" (before August 23, 2008), Basic medical expenses incurred from July 1 of the current year to the month of payment.

Retroactive settlement method for residents’ medical insurance benefits:

1. The retrospective settlement method for inpatient medical benefits adopts the method of “the patient pays the deposit first, and the hospital delays settlement”.

Starting from July 1, 2008, when designated medical institutions handle discharge settlement for inpatients with local household registration who have participated in or are preparing to participate in resident medical insurance but have not yet been able to enjoy the benefits, they must contact the insured patient. After negotiation, a deposit equal to the hospitalization medical expenses can be collected.

After discharged patients can enjoy the benefits of resident medical insurance, starting from August 1, 2008, they can apply for medical expense accounting at the original hospital medical institution with their resident medical insurance card, valid identity document, deposit receipt, and discharge certificate. Settlement.

After confirming the identity and benefits of the insured person on the medical insurance information system, the designated medical institution will go through the admission registration and discharge settlement procedures and immediately refund the deposit equal to the billable medical expenses.

2. The medical benefits for emergency stays and other specific outpatient items and designated chronic diseases within the approval period will be handled retrospectively in the same way as inpatient medical benefits.

3. General outpatient (emergency) outpatient medical treatment benefits are retrospectively handled in the manner of "selected medical institutions handle sporadic reimbursement on behalf of others".

Since October 31, 2008, selected medical institutions have begun to accept sporadic reimbursement applications for basic outpatient (emergency) medical expenses incurred by insured persons in the medical institution during the benefit retroactive period.

The steps for selecting a medical institution to handle sporadic reimbursement of outpatient (emergency) medical expenses are as follows:

(1) The insured person goes to the selected medical institution where the medical expenses originally occurred to fill out the " Guangzhou Urban Resident Medical Insurance Outpatient (Emergency) Medical Expenses and Medical Insurance Benefit Retrospective Application Form" (hereinafter referred to as the "Application Form"), and present the resident medical insurance card, valid ID and "Medical Insurance Outpatient Medical Record", and submit the original resident medical insurance card at the same time Copy of the reverse side, original medical expense receipt (invoice), and details of medical expenses.

The selected medical institution will immediately review and confirm the information, stamp the "Application Form", and give the receipt to the insured.

(2) The selected medical institutions will summarize the zero-report application data for residents’ outpatient (emergency) outpatient treatment benefits on a monthly basis, and fill in the "Guangzhou Urban Resident Medical Insurance" outpatient (emergency) outpatient medical expenses for selected medical institutions Retrospective Declaration Summary Form" (hereinafter referred to as the "Declaration Form").

The selected medical institutions will send the application materials and "Application Form" submitted by the insured to the municipal medical insurance center office every month to handle sporadic reimbursement of outpatient (emergency) medical expenses.

(3) After the Municipal Medical Insurance Center accepts and reviews the zero-report application materials for retroactive residents’ outpatient (emergency) clinic benefits, it will directly transfer the fees paid by the resident medical insurance fund to the bank with the insured’s resident medical insurance card. Personal billing account.

(27) Settlement across social security years

Continuous hospitalization and outpatient treatment for specific items across social security years must be settled in segments according to the social security year, and the medical expenses incurred shall be settled according to the social security year. Each year is accumulated separately, and only one hospitalization deductible is calculated.

(28) Cross-insurance settlement

If the insured’s medical insurance benefits change during hospitalization (such as resident medical insurance being converted to employee medical insurance, or employee medical insurance being converted to resident medical insurance) Medical insurance), segmented settlement is required, and the medical treatment standard is calculated according to the relevant standards that should be enjoyed at the time of settlement, and only the minimum payment standard for one hospitalization is calculated.

8. Sporadic reimbursement of medical expenses

(29) Scope of sporadic reimbursement of medical expenses

The following expenses fall within the scope of sporadic reimbursement of medical expenses:

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1. Upon approval, the insured person’s medical expenses are in compliance with the regulations for hospitalization or emergency stay in non-city social insurance designated medical institutions due to illness, emergency treatment or rescue, or special needs of the condition;

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2. The basic medical expenses that have been advanced by the insured cannot be settled at designated medical institutions due to objective reasons, and the designated medical institutions cannot make up for the system settlement;

3. Within the retrospective scope of residents’ medical insurance benefits, designated medical institutions will reimburse sporadic basic medical expenses for ordinary outpatient (emergency) outpatient services;

4. Out-of-town medical treatment in compliance with Article (17) of these rules range of basic medical expenses.

(Thirty) Sporadic reimbursement methods

Insured persons should apply for sporadic reimbursement to the Municipal Medical Insurance Center within 3 months from the date of settlement of medical expenses with the following information .

1. The original and a copy of the front and back of the resident medical insurance card;

2. A detailed list of medical expenses (or a manual record list certified by a medical institution);

3. Medical fee receipts or invoices printed by the finance and taxation department;

4. "Medical Insurance Outpatient Medical Records" or "Off-site Medical Treatment Record Book" and other information.

With complete information, the Municipal Medical Insurance Center will complete the review and settlement within 40 working days and transfer the fees paid by the resident medical insurance fund to the bank personal settlement account of the insured's resident medical insurance card; For difficult cases or special circumstances that require on-site verification, it will take no more than 90 working days to complete the review and settlement.

When the Municipal Medical Insurance Center confirms that the information is incomplete, it should notify the insured at one time to complete the missing information; if it concludes that payment will not be made after review, the insured should be informed within 40 working days.

9. Others

(31) Social Medical Assistance Management

After residents in need confirmed by the civil affairs department enjoy the benefits of resident medical insurance, they will be provided with medical assistance according to relevant regulations. It is stipulated to enjoy social medical assistance again, and the specific measures shall be implemented in accordance with the relevant regulations of the civil affairs and other departments.

(32) Implementation starting time and time limit

These implementation rules shall come into effect from the date of promulgation and shall be valid for three years. Upon expiration of the validity period, it will be evaluated and revised in accordance with the implementation situation.

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