淄博市统一医疗保障经办服务办事指南

 

淄博市统一医疗保障经办服务办事指南目录

 

一、职工医疗保障··································1

1.医疗保险参保登记·································2

1.1单位基本医疗保险参保登记···························· 2 

1.2职工基本医疗保险参保登记···························· 6

1.3灵活就业人员基本医疗保险参保登记························ 10

1.4单位变更登记·································· 14 

2.医疗保险关系转移接续·······························18 

  2.1医疗保险关系转出······························ 18 

  2.2医疗保险关系转入······························ 23 

3.参保缴费信息查询·································28 

  3.1单位参保缴费信息查询···························· 28 

  3.2个人参保缴费信息（个人权益记录）查询··················· ·32 

4.医疗保险个人账户一次性支付····························36 

5.参保地就医持卡联网结算······························40 

6.异地就医备案···································43 

  6.1长期异地就医备案······························ 43 

  6.2转外就医备案································ 47 

  6.3异地急诊转住院联网备案··························· 53 

7.医疗费用手工报销································ 57 

  7.1长期异地就医备案人员住院医疗费用手工报销··················57 

  7.2长期异地就医备案人员门诊慢性病医疗费用手工报销···············62 

  7.3转外就医医疗费用手工报销 ·························66

8.门诊慢特病病种待遇认定····························· 71 

9.生育保险待遇核准支付······························ 76 

9.1生育医疗费支付······························· 76 

9.2计划生育医疗费支付····························· 81 

9.3生育津贴支付································ 85 

10.医疗救助对象手工（零星）报销························· 89 

二、城乡居民医疗保障·······························93 

1.医疗保险参保登记································94

1.1城乡居民基本医疗保险参保登记························ 94 

1.2学生基本医疗保险参保登记·························· 98 

2.参保地就医持卡联网结算···························· 102 

3.异地就医备案································· 105 

3.1长期异地就医备案····························· 105 

3.2转外就医备案······························· 109 

3.3异地急诊转住院联网备案·························· 115 

4.医疗费用手工报销······························· 119 

4.1长期异地就医备案人员住院医疗费用手工报销················· 119 

4.2长期异地就医备案人员门诊慢性病医疗费用手工报销·············· 124 

4.3转外就医医疗费用手工报销························· 128 

5.门诊慢特病病种待遇认定···························  133 

6.生育医疗费支付································ 138 

7.医疗救助对象手工（零星）报销························· 142 

三、协议定点医药机构······························ 146 

1.新增协议定点医药机构····························· 147 

2.基本医疗保险定点医疗机构费用结算······················· 152 

3.基本医疗保险定点零售药店费用结算······················· 157

 

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