In order to carry out international medical settlement, the toll office sets up a special window for international medical insurance settlement, which is responsible for relevant reimbursement applications.
When handling admission, you need to confirm the relevant information according to the following steps:
(1) Check the validity period of the insured's membership card and identity certificate (such as passport and ID card)
(2) the percentage of deductible and conceited percentage is 0 or the "direct payment service" can be enjoyed in all public hospitals in Chinese mainland, so that the insurance direct payment service can be enjoyed, otherwise the patient will have to pay for his own expenses.
(3) If it is an inpatient, it is necessary to fill in the prior authorization form 2 working days before admission procedures and send it to the insurance company (emergency medical treatment can go through the formalities within 48 hours after treatment), and the insurance company will issue the expense guarantee letter.
When handling the discharge, the claim application shall be initiated according to the following steps:
(1) When the patient leaves the hospital, the list of medical expenses, the original medical invoice, the discharge summary, the letter of guarantee, the copy of identity certificate (when the medical expenses exceed 10000) and other claim settlement materials to be retained. The toll collector shall make a registration and be signed by the patient for confirmation.
(2) On the 30th of each month, the window shall make a unified settlement of the medical expenses of the insured in the current month and fill in the claim application form.
(3) Before the 5th of the next month, express the medical expense list, original medical invoice, discharge summary, letter of guarantee and claim settlement application form to the insurance company for verification.
(4) All claims should be submitted to the insurance company within 180 days after the patient's admission.