Wenzhou will suspend all medical insurance services from February 26.Please prepare in advance

2022-05-14 0 By

According to the unified deployment of the state and Zhejiang Provincial Medical Security Bureau, Wenzhou will stop using the existing medical insurance information system and switch to the online national medical security information platform (Zhejiang Provincial “smart medical insurance” platform).Down time and recovery time: From 0:00 on February 26, 2022 to 24:00 on March 6, 2022, all medical insurance services (including online and offline services) will be suspended in the city.Real-time settlement downtime: From 0 o ‘clock on March 4, 2022 to 24 o ‘clock on March 6, 2022, all real-time medical insurance card settlement will be suspended in the city.Recovery time: From 0:00 on March 7, 2022, the window business of municipal medical insurance agencies will be resumed, and real-time card settlement of municipal medical insurance will be resumed.Online services will resume later.Units involved in downtime and units involved in channels:City at the corresponding level and various counties (city, area) medical insurance agency orgnaization, towns (street), the village (community), convenient service center (station), the “medical cooperation” silver bank outlets, all the medical establishment that decide a dot in the city, wenzhou city smart card service co., LTD., the tax authorities, “health care in zhejiang, wenzhou merchant protect” undertaking institutions, to undertake long-term care insurance agency and designated care facilities, etc.Channels involved: Zhejiang Government Affairs Service Network, Zhejiang Provincial Office APP, national medical insurance registration mini program, county (city, district) online declaration system, medical insurance business related “one thing” joint office and other online and self-service channels.It is recommended that you handle such services as medical treatment, drug purchase, insurance participation and payment in the following ways: ① During the shutdown period (0:00 on March 4, 2022 to 24:00 on March 6, 2022), the local outpatient service fee shall be paid in full advance by the insured.Among them, the outpatient expenses incurred in local (wenzhou city, the same below) designated medical institutions will transmit the data during shutdown to medical insurance agencies synchronously after the system is switched online, and medical insurance agencies at all levels will initiate reimbursement and payment business for the insured.Before June 30, the actual reimbursement expense paid by the insured will be directly paid to the bank account of the insured’s social security • citizen card, and the insured need not go to the handling window to handle manual reimbursement.Participants with chronic diseases who need long-term medication should purchase drugs at relevant designated medical institutions in advance before the shutdown of real-time settlement (before 0 o ‘clock on March 4, 2022), and prepare enough drugs needed.(3) Discharge settlement “Timely Office” will switch over the original medical insurance information system due to the launch of “smart medical insurance” system. Designated medical institutions shall complete the settlement of medical expenses for all inpatients insured by medical insurance according to the requirements, as follows:For insured persons who meet discharge conditions before the real-time settlement shutdown (before 0 o ‘clock on March 4, 2022), designated medical institutions can directly handle discharge settlement procedures for them.For insured persons (including dialysis and home bed, etc.) who are admitted to hospital before the real-time settlement shutdown (before 0:00 on March 4, 2022) and need continuous long-term hospitalization, they should first go through the medical insurance discharge settlement procedures before the real-time settlement shutdown, and then go through the medical insurance transfer procedures at their own expense after the new system goes online.During the shutdown period of real-time settlement (0 o ‘clock on March 4, 2022 to 24 o ‘clock on March 6, 2022), the insured persons (including dialysis and home bed, etc.) who are newly hospitalized and expected to be discharged after the launch of the new system can be directly admitted at their own expense and transferred to medical insurance at their own expense after the launch of the new system.For subscribers who need to discharge from hospital during the shutdown period (0:00 on March 4, 2022 to 24:00 on March 6, 2022) due to special circumstances such as referral, they need to advance their medical expenses. After the new system goes online,Then bring the original medical bill (or electronic bill), medical expense list, discharge summary, medical insurance electronic voucher (or social security • citizen card), my bank card and other materials to the local medical insurance office window for manual reimbursement.(4) Out-of-place medical treatment “Window office” For insured personnel in Our city who seek medical treatment in designated medical institutions outside the province, the medical expenses during the downtime of real-time settlement (0 o ‘clock on March 4, 2022-24 o ‘clock on March 6, 2022) shall be paid in advance. After the new system goes online,Then bring the original medical bill (or electronic bill), medical expense list, discharge summary, medical insurance electronic voucher (or social security • citizen card), my bank card and other materials to the local medical insurance office window for manual reimbursement.(5) During the shutdown period of the “rescheduled” business (0:00 on February 26, 2022 — 24:00 on March 6, 2022), the insured who need to be referred to designated medical institutions outside the province due to their illness shall pay the medical expenses in advance. After the new system goes online,And issued by the local medical institutions to carry the basic medical insurance ginseng protect personnel to go to a doctor for the record table of original medical bills and long-distance medical (or electronic instrument), medical treatment charge list, discharge summary, health care electronic documents (or social security, citizen CARDS), my bank card, such as material, after the recovery business for a long distance for the record, in accordance with the provisions, apply for reimbursement by hand.(6) Insurance registration “first accept” basic medical insurance for employees: during the shutdown period of business handling (0:00 on February 26, 2022-24:00 on March 6, 2022), eligible individuals or units who fail to handle insurance registration in time can apply for reprocessing related business in March, overdue will not be handled.Please relevant units and individuals ahead of schedule or delay to deal with insurance registration business.Basic medical insurance for urban and rural residents:During the period of business shutdown (0:00 on February 26, 2022 to 24:00 on March 6, 2022), individuals who need to apply for urban and rural residents’ medical insurance coverage in 2022 (including “One Thing After Birth” resident medical insurance coverage) can first submit application materials to the local medical insurance agency, and the medical insurance agency will handle the application after the business operation resumes.● During the business shutdown period (0:00 on February 26, 2022 to 24:00 on March 6, 2022), the city’s medical insurance agencies will normally provide medical insurance consulting services. For individuals and units who really need to handle medical insurance business, the application materials will be accepted through the handling window and handled in time after the resumption of various business matters.The validity period of sporadic reimbursement is one year. It is suggested to stagger the peak period in the early stage of system launch.● The city’s two ding medical institutions to take various measures to facilitate the people, and do a good job of publicity and explanation, minimize the impact of system switching online to insured people.● If it is not necessary, please avoid the shutdown period (0:00 on February 26, 2022 — 24:00 on March 6, 2022) for the majority of insured persons who intend to handle medical insurance business.● After the launch of the National medical security information platform, there may be delays in the service of medical insurance due to network difficulties, system instability, increase of offline business and other factors, please understand the masses of insured people, relevant units and all sectors of society.● If you have any questions, you can pay attention to “Wenzhou Medical Insurance”, “Wenzhou Medical Insurance Management Center” and the wechat public account of each county (city, district) medical insurance bureau. You can also call the mayor’s hotline 12345 or the consultation telephone of medical insurance agencies around the country.Consultation telephone (working hours) City level: 0577-88863716 Lucheng District: 0577-88129816 Longwan District: 0577-85987026 Ouhai District: 0577-88591986 Dongtou District: 0577-63485730 Leqing City: 0577-61600996 Ruian City:0577-65895523 Yongjia County: 0577-57991299 Wencheng County: 0577-67861947 Pingyang County: 0577-58108778 Taishun County: 0577-67583322 Cangnan County: 0577-64700938 Longgang City: 0577-68669952Why should the National Medical Security Information Platform be launched?A: In order to further promote the digital reform of the Medical Security Bureau of Zhejiang Province, according to the unified deployment of the National and Zhejiang Provincial Medical Security Bureau, the city will stop using the existing medical insurance information system and switch to the online national Medical security information platform (zhejiang Provincial “smart medical insurance”).Are long-term care insurance applications suspended during the outage?Answer: do not affect, still apply for acceptance by former channel, by ginseng protect personnel and its family member to its ginseng protect place to administer long protect risk undertake orgnaization to put forward application, after evaluating through expert, those who accord with the condition enjoy long protect risk treatment by relevant standard.During the downtime, will the long-term care insurance treatment be affected?Answer: do not affect, long-term nurse insurance pay enjoys personnel to still enjoy basic life to take care of and the medical treatment that is closely related with basic life by former channel nurse service.During the downtime, will sorbic’s subscribers be affected?Answer: it will have certain impact on individual account deduction payment.The use of personal accounts for the insured themselves withholding, we have in the shutdown through the way of withholding, the insured personnel do not need to repeat the insurance, can be through the “Wenzhou Yikang” public account to inquire the details of insurance and deduction;Insurance participants who use their own accounts for their children, spouse or parents to participate in the health insurance will not be able to do so during the shutdown period. They can participate in the health insurance payment through wechat or Alipay by using Alipay, Citizen card APP, Wenzhou Health Insurance official account, etc.During the downtime, whether there is any impact on the treatment enjoyment of Sorbic?A: After March 4, insured people will not be able to achieve “one-stop” credit card settlement.We will automatically obtain the medical treatment information of the insured, manually make up the difference, and then pay to the account of the insured through the citizen card or the union Pay card number stored in the system, and inform the insured personnel of the compensation difference by phone, basically realizing “zero escape”.Review: Qian Zhongbiao, Director, Supervisor, Chen Taichang, Supervisor, Wu Xiao, Chen Xiyu, Chief Supervisor, Chen Zhenshi