Original title: The list of key matters for medical insurance to "do one thing efficiently" was released (theme).
The direct settlement of inter-provincial expenses for outpatient chronic diseases will be expanded (subtopic).
Recently, the National Medical Security Administration issued the "Notice on Promoting "Efficient Completion of One Thing" in the Field of Medical Security Services (hereinafter referred to as the "Notice"), which clarified the list of key matters for medical insurance in 2024.
The notice pointed out that the promotion of offline services "only one door", the service will be delivered to the masses and enterprises, and "one-stop service, one window handling, and one single system settlement" will be realized; Promote cross-domain handling of non-local matters, optimize cross-regional transfer and continuation of relationships, and continue to improve direct settlement services for remote medical treatment; Promote the "one-network service" of online services, realize more medical insurance services online, in the palm of your hand, and in the first place, improve the level of online services throughout the process, provide intelligent service guidance, and realize more matters "enjoy without application"; Promote the "first-line response" to appeals, and continuously improve the efficiency of medical insurance consulting services; Improve the level of "humanized" services, promote the parallel innovation of traditional service models and intelligent services, narrow the difference in service experience, and ensure that different groups of people enjoy services equally.
In this year's list of key matters, there are 8 service items involving insured personnel, and the service content is clarified. Implement the "birth of one thing" for newborns, newborns can apply for medical insurance with household registration or birth medical certificates, and maternity medical expenses can be reimbursed in a "one-stop" manner, without the need to run errands and submit materials to multiple departments; Implement the joint office of "retirement one thing" for employee retirement, and cooperate with the pension agency to carry out the retirement procedures for employees, which can be jointly handled through information sharing, without the need to run errands and submit materials to multiple departments; Implement the "one thing" of social security cards and medical insurance codes for medical treatment and drug purchases, support social security cards for medical treatment and drug purchases, promote more convenient medical treatment and drug purchase with medical insurance codes, realize mobile payment, and shorten the time for queuing for medical treatment and drug purchases; Realize that medical assistance recipients can enjoy the subsidy and insurance without application; The "maternity allowance review and payment" will be completed within 10 working days; Realize the online handling of "employee medical insurance personal account family mutual aid"; Provide inquiry services such as insurance payment status, treatment enjoyment, transfer and continuation progress, employee medical insurance personal account, annual reimbursement and other services; The scope of direct settlement of outpatient chronic disease inter-provincial expenses has been expanded, and the number of diseases has been added on the basis of the direct settlement of outpatient chronic disease inter-provincial expenses for the existing 5 diseases (hypertension, diabetes, outpatient radiotherapy and chemotherapy for malignant tumors, uremia dialysis, and anti-rejection after organ transplantation**).
The National Health Insurance Administration said that it will launch a number of key items of "doing one thing efficiently" year by year to continue to promote the quality and efficiency of medical insurance services. Encourage medical insurance departments at all levels to reform and innovate based on local conditions, boldly explore, and strive to make greater breakthroughs in key areas and key matters.
*: China Consumer Daily.