异地就医结算年底覆盖全省 Different ground settlement cover all the doctor at the end of the year

目前已覆盖佛山、珠海等12个地市，但尚未涵盖广州、深圳、东莞 Has covered foshan、Zhuhai 12 cities，But not yet covers guangzhou、shenzhen、The dongguan

　　昨日，我省召开《广东省“十二五”期间深化医药卫生体制改革实施方案(征求意见稿)》座谈会。记者从会上获悉，作为“十二五”期间深化医药卫生体制改革的重要内容，日前广东省人力资源和社会保障厅专门召开会议，部署全面推进全省基本医疗保险异地就医即时结算工作。

yesterday，Held in our province《Guangdong province“1025”Deepening the reform of the medical care system during implementation plan(Draft version of the)》symposium。The reporter learns from the meeting，as“1025”During the reform of medical care system in deepening the important content，Guangdong province by human resources and social security hall special meeting，The deployment of the whole province comprehensively promote the basic medical insurance different ground settlement doctor immediately。

　　根据部署，在今年底前，广东将建成覆盖全省、互联互通的全省异地就医联网结算系统，实现省内异地就医即时结算；到2015年，初步实现跨省医疗费用异地即时结算，进一步提升异地就医机制的普惠性、便捷性和安全性。

According to the deployment，By the end of the，Guangdong will cover all the built in、The doctor of interconnected different networking and settlement system，Realize the province beyond the immediate medical settlement；By 2015，Preliminary realize medical treatment cost spanning provinces different instant settlement，To further improve the mechanism of different medical pratt &whitney、Convenience and safety。

探索??异地就医享受参保地待遇 explore??Different ground to enjoy treatment of medical treatment ginseng

　　在韶关参加基本医疗保险的参保人以后来广州就医，将不再需要自己先垫付、出院后再回参保地结算统筹范围内的医疗费，而只需一张医保卡，一切就可在就医地即时搞掂。

In shaoguan attend insurance of primary medical treatment after the ginseng of people come to guangzhou medical attention，Will no longer need to payment first、After discharge to plan as a whole to go back to ginseng protect settlement within the scope of the medical treatment cost，And just a health insurance card，All can fix to go to a doctor in real-time。

　　记者从昨日的会上了解到，根据日前出台的《广东省基本医疗保险异地就医即时结算工作方案》，包括异地居住、驻外工作(学习)达6个月以上以及因病转外就医在内的异地就医人员，按照参保地规定办理异地就医手续后，即可即时结算在异地就医定点医疗机构住院发生的医疗费用。

Reporters from yesterday's meeting to understand，According to law of before《The basic medical insurance of guangdong province different settlement scheme doctor immediately》，Including different living、Outside work(learning)Up to 6 months above and turn because of illness, the different medical doctor personnel，In accordance with the provisions of the medical treatment to ginseng protect different procedures，Can instantly calculated in different places to nod medical establishment go to a doctor of hospitalization occurs medical costs。

　　“按照‘享受参保地待遇，委托就医地管理’的原则，参保人在所选定的异地就医定点医疗机构就医时，将根据参保地规定的起付线、支付比例、最高支付限额以及广东省基本医疗保险药品目录、诊疗项目和医疗服务设施标准等享受医疗保险待遇。”省人社厅有关负责人表示。

“According to‘Enjoy ginseng protect to treatment，Entrust to medical management’principle，Ginseng protect their selected different ground to nod medical establishment go to a doctor when go to a doctor，According to the provisions of the will to ginseng protect the fu biao since the line、Pay scale、Highest pay limitation and basic medical insurance of guangdong province catalog of medicines、Diagnosis and treatment programs and facilities of medical treatment service standard, enjoy treatment of medical treatment insurance。”Province people club hall about chief said。

　　那么，如何实现异地就医即时结算？据介绍，参保人发生异地就医行为后，定点医疗机构将会把参保人异地就医的医疗费用信息通过就医地医保信息系统发送至省异地就医联网结算平台，由省异地就医联网结算平台转送参保地经办机构审核，参保地审核确认后再将信息返回省异地就医联网结算平台，由省异地就医联网结算平台通过就医地医疗保险信息系统转送医疗机构。

so，How to realize the different medical instant settlement？According to introducing，Ginseng protect a person has different ground after medical treatment behavior，The medical establishment that protects a person will take the different medical treatment cost of medical information through the medical health care information system to be sent to the provinces beyond the medical network settlement platform，By the province beyond the networking settlement transferred to ginseng protect medical platform to orgnaization of agency of the audit，Ginseng protect reviews the confirmation will return again different medical information province networking settlement platform，By the province networking settlement platform through different medical doctor to transfer information system of insurance of medical treatment of medical institution。

　　“医疗费用经参保地经办机构审核确定后，应当由参保人承担的，由参保人直接支付给医疗机构；应当由医疗保险基金支付的，由参保地经办机构根据与就医地经办机构约定的结算办法，核算结算金额，在参保人出院次月，通过就医地经办机构支付给医疗机构。”省人社厅有关负责人称，这样的结算办法可以更好地发挥团购优势，促进医疗机构合理检查、合理治疗、合理用药、合理收费，有利于进一步提高医疗保险基金的使用效率。

“Medical cost is to determine the orgnaization of agency of ginseng after review，Shall be liable for the by ginseng protect，By ginseng protect people directly pays medical institutions；Should be made by the fund of medical treatment insurance to pay，By ginseng protect orgnaization of agency of medical treatment according to the land and to agency orgnaization agreed terms for the settlement of measures，Accounting settlement amount，Protects a person in the following month, the discharge，Through the orgnaization of agency of medical treatment to pay medical institutions。”Province people club hall officials say，Such settlement way to better play to the advantages of bulk，Promote medical institutions reasonable check、Reasonable treatment、Rational drug use、Reasonable charge，To further improve the efficiency in the use of medical insurance fund。

　　中山大学岭南学院财税系主任林江告诉南方日报记者，异地就医即时结算不但体现出惠民性、公平性，也从某种程度上激发了医疗机构的积极性。“以前异地就医的结算方法过程冗长，手续繁多，导致部分医疗机构为免麻烦甚至拒收异地患者。”

Zhongshan university lingnan college finance and tax the dean Lin jiang told southern daily reporter，Beyond the immediate settlement not only reflect the doctor huimin sex、fairness，Also from some extent inspired the enthusiasm of the medical institution。“Different methods of settlement of medical treatment before long process，Various procedures，In some medical institutions to avoid trouble or even rejected different patients。”

　　根据规划，全省异地就医结算管理系统将按照先联接后完善、先住院后门诊大病、先省内后跨省的步骤逐步推进。今年底前，全省将全面实行住院异地就医多向联网结算，并争取在2013年12月底前，实现门诊特定病种异地就医多向联网结算。

According to the plan，The different ground settlement management system will be in accordance with the doctor first after connection perfect、First after be in hospital outpatient service a serious illness、After the first province to promote the gradual steps across the province。Before the end，The province will to implement different medical hospital multi-way networking settlement，And for the 2013 before the end of December，Realize the specific disease outpatient service medical treatment beyond the multiplex networking settlement。

进展??12地市26家三甲医疗机构联网 progress??12 cities top 26 medical institutions networking

　　省人社厅有关负责人介绍，自2010年3月初步建成异地就医结算管理平台并正式上线运行以来，目前已与佛山、珠海等12个地市、26家三级甲等医疗机构联网，共为1.7万人次提供异地就医结算，结算金额达4.7亿元。

Province people club hall concerns chief introduction，From March 2010 initially set up different ground settlement management platform and formal medical online since its operation，At present already and foshan、Zhuhai 12 cities、26 three level of first-class medical institutions networking，Of 17000 people go to a doctor to provide different ground settlement，Settlement amount of 470 million yuan。

　　“虽然当前省级异地就医结算管理平台已经与12个地市联网，但尚未涵盖广州、深圳、东莞等异地就医量较大的城市；全省各地实行的异地结算方式中，更多的是各市单向与广州定点医疗机构联网结算，并未实现双向、乃至多向的互联互通，缺乏异地协管；加上省市异地结算平台的重复建设，也使定点医疗机构结算手续变得繁琐，影响医疗机构积极性。”

“Although the current provincial medical management platform has different settlement with 12 cities networking，But not yet covers guangzhou、shenzhen、Dongguan, doctor of the major cities of the different quantity；The province of different ground settlement in a way，More is various cities and guangzhou one-way nod medical establishment networking settlement，Did not realize two-way、And even the multiplex interconnected，Lack of different ground assisting；With different provinces and cities repetitive construction settlement platform，Also make the medical institutions settlement procedures become complicated，Medical institutions influence enthusiasm。”

　　因此，省人社厅有关负责人表示，推进省内异地就医多向联网即时结算工作，短期目标就是要在年底前把覆盖全省、互联互通的全省异地就医联网结算系统搭建起来。

so，Province people club hall about chief said，The province of different multi-way networking instant settlement medical work，Short-term goal is to before the end of the year to cover the whole province、The doctor of interconnected different networking and settlement system set up to。

　　该负责人称，接下来将积极扩大医保信息系统覆盖面，实现医疗机构、基层服务网点、各级经办机构的联网全覆盖，同时加快社会保障卡的发放，使其成为异地就医的重要身份凭证和服务手段。(记者 刘熠 实习生 许晓冰)

The officials say，The next will actively expand health care coverage to information system，Realize medical institutions、Grassroots service networks、At all levels of complete coverage of orgnaization of agency of networking，And speed up social security card extend，Make it a different ground treatment identity documents and an important service means。(Reporter LiuYi interns XuXiaoBing)