[Source: Nanguo Zaobao WeChat]
Some special chronic diseases require long-term outpatient treatment to purchase medicines. On July 31, the reporter learned from the Autonomous Region Medical Security Bureau that at present, 5 outpatient special chronic diseases have been opened in 7 coordinating regions including Beihai, Wuzhou, Nanning, Qinzhou, Baise, and Chongzuo. Cross-province direct settlement service. When the eligible insured seeks medical treatment across provinces, the outpatient special chronic disease-related treatment expenses can be directly settled.
These five outpatient special chronic diseases are hypertension, diabetes, uremic dialysis, anti-rejection therapy after organ transplantation, and outpatient radiotherapy and chemotherapy for malignant tumors.
According to the requirements, the insured personnel seeking medical treatment in different provinces and different places directly settle the treatment expenses related to 5 outpatient special chronic diseases, and must meet three conditions.
①The insured person has obtained the qualification for special chronic disease treatment in the outpatient clinic of the corresponding disease, and has gone through the record for medical treatment in other places according to the policy of the insured place. The insured person in Guangxi needs to apply for outpatient special chronic disease medical treatment at the same time when seeking medical treatment in other provinces. Medical institution registration;
②The insured place where the insured person is located has opened the corresponding outpatient special chronic disease cost inter-provincial direct settlement service;
③The designated medical institution for the insured person to see a doctor has opened Cross-provincial direct settlement services for corresponding outpatient special chronic diseases.
In terms of reimbursement policy, the outpatient special chronic disease expenses directly settled by cross-provincial and non-local medical personnel shall, in principle, be subject to the scope of payment and relevant regulations (basic medical insurance, drugs, medical service items and medical consumables, etc.) payment range). Reimbursement policies such as the basic medical insurance fund’s starting payment standard, payment ratio, and maximum payment limit shall be governed by the regulations of the place of participation. That is, “directory of medical treatment places, policy of insured places”.
In Guangxi, as of July 29, 133 hospitals, including the People’s Hospital of the Autonomous Region, the First Affiliated Hospital of Guangxi Medical University, and the People’s Hospital of Baise City, have opened outpatient treatment for special chronic diseases. Cross-province direct settlement service. The outpatient special chronic disease-related treatment expenses are directly settled across provinces, and the service must be opened in the place where the insured is insured, the place where the insured seeks medical treatment, and the medical institution for medical treatment. Insured persons can inquire about relevant information through the website of the National Medical Insurance Service Platform, the “National Medical Insurance Service Platform” App and other channels.
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