Online and offline reporting are the same, health insurance benefits are not discounted

On November 2, the National Health Security Administration issued “Guiding Opinions on Active Promotion” Internet + “of Medical Services and Health Insurance Payments”, clarifying that eligible Internet medical institutions can voluntarily “enroll” in insurance physician through the physical medical institutions on which they depend. In a fixed range, the “Internet +” health insurance payment will adopt a consistent online and offline refund policy. The health insurance department will deal fairly, promote fair competition between online and offline services, and further promote the development of the “Internet +” medical services business.

In the past, the “Internet +” health insurance payment had a phenomenon where it was difficult to balance comfort and well-being. Online payment is really very convenient and popular with people. However, the choice of this payment method sometimes requires the transfer of some benefits. Either the health insurance reimbursement catalog is not complete enough or the reimbursement rate has decreased. Also, some places don’t support online payment, some adopt different policies for inpatient and outpatient clinics, and some reimburse drug costs, but not medical exam fees. When patients choose to pay online, health insurance reimbursement benefits can be discounted.

After the National Health Insurance Office publishes this document, differences in local policies will be eliminated. It will no longer be a dilemma for people to choose wellness or convenience. In this way, although the health insurance fund is divided into online and offline payments, the only change is the payment method. The only thing that remains unchanged is the protection of benefits, including the scope of payment and the strength of the protection, and they will no longer be treated differently due to different payment methods. Although there are great difficulties to do so, for example, on a technical level, online payment is much more complicated than offline payment, involving technical and management problems such as circulation of prescriptions and payment to third parties. However, in order not to detract from the well-being of patients, the health insurance department must take greater responsibility and provide patients with more comfort and better well-being through technological updates and regulatory improvements.

During the new corona pneumonia epidemic, to enable chronic disease patients to obtain necessary medications in a timely manner via the Internet and to ensure that their health insurance benefits are not adversely affected by paying online, the The medical insurance department temporarily introduced a policy of constant reimbursement online and offline, especially during special periods. Good practice has become universal policy: not only will chronic disease patients have long-term guarantees for online reimbursement, but other patients will benefit as well. Especially in the context of the policy reform of the employee health insurance personal account and the reimbursement of ordinary outpatient expenses by the health insurance, the consistent reimbursement policy is introduced online and offline, and the two will promote and expand each other.

It should also be noted that consistent online and offline reimbursement not only treats different reimbursement channels equally, it also treats different online and offline medical institutions equally. Reimbursements for medical treatment at physical medical institutions can still be refunded if online is not available. However, due to the distance between doctors and patients during diagnosis and treatment of Internet medical institutions, if the reimbursement cannot be made online, there is no possibility of reimbursement offline. From this perspective, after achieving consistent reimbursements online and offline, the internet diagnosis and treatment will undoubtedly benefit the most. This measure will solve the Internet diagnosis and treatment reimbursement problem and promote the rapid development of Internet diagnosis and treatment.

It should also be noted that the online health insurance payment reform is not only based on the current situation, but also reserves room for future development. The current payment for health insurance online is mainly limited to the coordinated area. The next step will support the local exploration of the direct settlement of out-of-town outpatient expenses and the transfer of electronic prescriptions through the coordinated areas. There are an increasing number of medical treatments in different places, allowing them to take advantage of the free payment for health insurance online, which will greatly benefit the migrant population to enjoy health insurance treatment in the same city, and it is a Great help for patients seeking medical treatment in different places.

It is foreseeable that with the implementation of this reform, in the future, not only will online and offline reimbursement be uniformly reimbursed, but local and remote medical treatment will also be uniformly reimbursed. The difficulty and cost of medical treatment is expected to be further alleviated.