Whether the outpatient department of Shanghai Eye Hospital accepts social insurance reimbursement
As a professional ophthalmic hospital in Shanghai, Shanghai Eye Hospital has always provided high-quality ophthalmic diagnosis and treatment services for patients. Many people will pay attention to whether they can be reimbursed through social security when they choose hospital outpatient services. So, does the outpatient department of Shanghai Eye Hospital accept social insurance reimbursement? The following is a detailed description of medical insurance policies, reimbursement methods, special circumstances and specific operating procedures.
Medical insurance policies and regulations
According to the national medical insurance policy, the social insurance reimbursement covers the basic medical insurance and serious illness insurance in all provinces and cities. As a developed province and city, Shanghai has a wide coverage of medical insurance. Therefore, the outpatient service of Shanghai Eye Hospital can accept social insurance reimbursement under certain conditions.
First of all, outpatient visits must be prescribed by qualified doctors. Secondly, the medical treatment items must be within the scope of medical insurance reimbursement, that is, they belong to the treatment items covered by the national medical insurance policy. For example, myopia surgery, cataract surgery, eye disease inspection, etc. are all covered by medical insurance reimbursement* After that, the reimbursement amount shall not exceed the proportion and limit specified in the medical insurance policy.
Social insurance reimbursement method
There are generally two ways to accept social insurance reimbursement in the outpatient department of Shanghai Eye Hospital. The first is to pay at your own expense, and then apply for reimbursement through the social insurance reimbursement window provided by the hospital. The patient submits the outpatient invoice, doctor's prescription and other relevant materials to the hospital, and the hospital will reimburse the corresponding expenses according to the reimbursement proportion and limit. The second way is to directly apply for reimbursement at the hospital by swiping the social security card. Just submit the outpatient prescription and the social security card to the hospital, and the hospital system will automatically calculate the reimbursement amount.
Special circumstances and operating procedures
In some special cases, there may be some additional operating procedures and regulations. For example, if the proportion of social insurance reimbursement is insufficient, patients can choose to use commercial medical insurance for reimbursement or pay at their own expense. In addition, some special diseases or treatment projects need to be applied for and approved by the hospital or social security department in advance.
The specific operation process includes the following steps. First, the patient went to the outpatient clinic of Shanghai Eye Hospital to register at the window and make an appointment with a doctor. Secondly, diagnosis and treatment shall be carried out according to the doctor's prescription, and fees shall be paid at the charging window. Then, the patient submits the expense bill and social security card to the window for reimbursement* Later, the hospital will make reimbursement according to the social insurance policy and return the reimbursement amount to the patient's social insurance account.
Summary
In short, the outpatient service of Shanghai Eye Hospital is reimbursed by social security. According to the medical insurance policy, as long as the medical items meet the medical insurance reimbursement scope, patients can reimburse some expenses through social insurance. In practice, patients can choose to pay at their own expense before reimbursement, or directly swipe the social security card for reimbursement. Under special circumstances, it is also necessary to comply with the relevant regulations and procedures of the hospital and social security department for application and handling. Patients can choose their own reimbursement method according to their needs to reduce their financial burden.
