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class="pageright"> <div id="rh7tdnnf" class="pageweizhi"> <span>醫(yī)保專欄</span> <div id="rh7tdnnf" class="wzrig">您當前的位置：<a href="/">首頁</a> > <a href="/ybzl/">醫(yī)保專欄</a> > <a href="/ybzl/ybzcwj/">醫(yī)保政策文件</a></div> </div> <div id="rh7tdnnf" class="pagexxbox"> <h1 class="ptitle">溫馨告知：關(guān)于全市醫(yī)保業(yè)務(wù)新老系統(tǒng)數(shù) 據(jù)割接期間相關(guān)工作的通知</h1> <div id="rh7tdnnf" class="ftitle"></div> <div id="rh7tdnnf" class="pdate">發(fā)布者：webadmin 作者：來源：發(fā)布時間：2018-12-25 08:35:44</div> <div id="rh7tdnnf" class="page_right_box_xinxi"><p><span style="font-size:16px;">　<strong>　一、醫(yī)保系統(tǒng)停機時間節(jié)點</strong></span></p> <p><span style="font-size:16px;">　　2018年12月29日20:00—2019年1月7日8:00為新老系統(tǒng)數(shù)據(jù)割接時間。在此期間系統(tǒng)將停止對外服務(wù)。2019年1月7日8:00新系統(tǒng)上線后，全市醫(yī)保業(yè)務(wù)通過新系統(tǒng)辦理(舊系統(tǒng)停止運作)。</span></p> <p><strong><span style="font-size:16px;">　　二、停機升級期間有關(guān)業(yè)務(wù)經(jīng)辦及費用結(jié)算</span></strong></p> <p><strong><span style="font-size:16px;">　　1、跨年度醫(yī)保病人住院結(jié)算工作</span></strong></p> <p><span style="font-size:16px;">　　1)已達到出院指征的醫(yī)保患者在12月28日開具出</span></p> <p><span style="font-size:16px;">　　院并辦理完出院結(jié)算。</span></p> <p><span style="font-size:16px;">　　2)今年無需進行年末斷帳處理，新系統(tǒng)上線后將自動調(diào)取費用發(fā)生時間進行計算，參保人所發(fā)生費用將按費用發(fā)生時間計入個人當年度費用累計。</span></p> <p><span style="font-size:16px;">　　<strong>2、參保人員醫(yī)院門診、住院<br /> 停機期間，門診、住院醫(yī)?；颊邊⒄兆再M患者管理，按照醫(yī)保政策執(zhí)行診療。</strong></span></p> <p><span style="font-size:16px;">　　<strong>門診：</strong>個人賬戶消費、門特就醫(yī)結(jié)算，系統(tǒng)停機期間到醫(yī)院就醫(yī)的，需個人全額現(xiàn)金結(jié)算。系統(tǒng)恢復后，再憑相關(guān)憑證來院補辦醫(yī)保結(jié)算。請參保人員留下聯(lián)系電話，在停機期間用現(xiàn)金結(jié)算但系統(tǒng)恢復后想用社會保障卡個人賬戶結(jié)算的患者和門特患者，在系統(tǒng)恢復后10 個工作日內(nèi)，持本人社會保障卡(未領(lǐng)取社會保障卡的參保人員持本人身份證、未成年人持戶口簿)、相關(guān)處方和發(fā)票，按照醫(yī)院退費流程，重新錄入醫(yī)保系統(tǒng)進行結(jié)算。</span></p> <p><span style="font-size:16px;">　　<strong>住院：</strong>參保人員在系統(tǒng)停機前已經(jīng)在院或在系統(tǒng)停機期間辦理入院的，需在停機期間辦理出院的，請留下聯(lián)系電話，系統(tǒng)恢復運行后10 個工作日內(nèi)，來院辦理出院結(jié)算。</span></p> <p><span style="font-size:16px;">　　<strong>3、參保人員轉(zhuǎn)院治療</strong></span></p> <p><span style="font-size:16px;">　　系統(tǒng)停機期間，因病情需要他院轉(zhuǎn)入我院或我院轉(zhuǎn)他院治療的參保人員，先按普通病人身份轉(zhuǎn)入(自費患者管理，醫(yī)保政策執(zhí)行)，做好停機期間的記賬工作，醫(yī)療費用暫由參保人員全額墊付，待系統(tǒng)恢復后，按照住院費用發(fā)生時間的先后，辦理出院結(jié)算。</span></p> <p><span style="font-size:16px;">　　<strong>參保人員異地就醫(yī)墊付費用報銷</strong></span></p> <p><span style="font-size:16px;">　　停機期間，暫停辦理異地醫(yī)療費用中心報賬手續(xù)，待系</span></p> <p><span style="font-size:16px;">　　統(tǒng)恢復后再進行單據(jù)審核報銷。</span></p> <p><span style="font-size:16px;">　　<strong>4、參保人員異地就醫(yī)聯(lián)網(wǎng)費用報銷</strong></span></p> <p><span style="font-size:16px;">　　停機期間，異地就醫(yī)住院相關(guān)業(yè)務(wù)可在系統(tǒng)恢復后繼續(xù)辦理;也可全額現(xiàn)金與醫(yī)療機構(gòu)結(jié)算，并將費用總清單、發(fā)票原件、身份證復印件、社會保障卡復印件等資料，交醫(yī)保局按規(guī)定審核報銷。</span></p> <p><span style="font-size:16px;">　<strong>　5、全面使用社會保障卡</strong></span></p> <p><span style="font-size:16px;">　　從2019年1月7日起試行全面使用社會保障卡醫(yī)保結(jié)算工作(同時廢止原醫(yī)保IC卡)。2019年1月7日至3月31日為過渡期，過渡期內(nèi)尚未辦理社會保障卡的人員可以使用身份證進行結(jié)算。2019年4月1日起全面采用社會保障卡進行醫(yī)保結(jié)算(學齡前兒童除外)。在4月1日前，沒有社會保障卡的參保人可以憑身份證原件就醫(yī)，但需填寫社會保障卡辦理告知書并按告知書提示盡快辦理社會保障卡。辦理注意事項可以在掛號室和醫(yī)保窗口的政策宣傳欄查看。</span></p></div> <div id="rh7tdnnf" class="spcenter_fenxiang"><span>分享到：</span> <div id="rh7tdnnf" class="bdsharebuttonbox"><a href="#" class="bds_more" data-cmd="more"></a><a href="#" class="bds_qzone" data-cmd="qzone" title="分享到QQ空間"></a><a href="#" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博"></a><a href="#" class="bds_tqq" data-cmd="tqq" title="分享到騰訊微博"></a><a href="#" class="bds_renren" data-cmd="renren" title="分享到人人網(wǎng)"></a><a href="#" class="bds_weixin" data-cmd="weixin" title="分享到微信"></a></div> <script> 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