Beijing Medical Insurance Affairs Management Center (2020) No. 90

Medical insurance departments in all districts and designated medical institutions:

According to the "Notice on Issues Related to the Application of Electronic Social Security Cards for Medical Treatment Settlement" (Beijing Municipal Medical Insurance Bureau (2020) No. 21) of Beijing Municipal Medical Insurance Bureau, we will enable electronic social security cards for medical settlement from January 1, 2021. To do a good job in the settlement of medical treatment for the city’s insured persons of basic medical insurance (hereinafter referred to as “insured persons”) with electronic social security cards, the relevant issues are hereby notified as follows:

I. Settlement for medical treatment with an electronic social security card

Insured person should ensure that the electronic social security card is in a normally activated state before paying at the designated medical institutions.

(1) Outpatient (emergency) service

1. Designated medical institutions will scan the electronic social security card of the insured person, read the historical treatment information online in real time, settle medical expenses, and issue charge receipts, prescriptions, cost details, etc. for the insured persons. Insured persons should pay medical bills not covered by medical insurance at their own expense.

2. Designated medical institutions should strictly implement real-name medical treatment regulation: For insured persons holding electronic social security card for medical treatment, doctors of designated medical institutions shall verify identity based on the insured person’s photo provided by the medical insurance information system. If the doctor’s workstation is equipped with facial recognition equipment, the insured persons can be identified by face scanning. The violation of medical insurance regulations such as taking medical treatment using another’s name should be stopped in time.

3. If an insured person needs to be referred for treatment due to a medical condition, doctors at the designated medical institution will issue a "Beijing Medical Insurance Referral (Hospital) Form", and the designated medical institution can scan the insured person's electronic social security card to advance the referral.

(2) Hospitalization business

1. Ordinary hospitalization

(1) The designated medical institution shall register the insured person after confirming the identity by scanning the electronic social security card on the day of admission.

(2) The designated medical institution should issue payment receipts, settlement vouchers and other documents for the insured person during the settlement. The insured should pay medical bills uncovered by the medical insurance at their own expense.

(3) After the designated medical institution registers the insured for hospitalization, it can cancel the registration by scanning the electronic social security card of the insured if they need to cancel the registration for some reason.

2. Outpatient clinics for special diseases, emergency observation, family beds, and outpatients can pay for medicines at a fixed proportion.

When the designated medical institution settles the medical expenses for special diseases, emergency observation, family beds, and outpatient clinics for the insured according to a fixed proportion, it shall issue bills of charges, settlement receipts, etc. for the insured. The insured should pay medical bills uncovered by medical insurance at their own expense.

3. Referral

If an insured person needs to be transferred for treatment due to certain medical conditions, doctors of the designated medical institution need to issue a ‘Beijing Medical Insurance Referral (Hospital) Form’, and the designated medical institution can scan the insured person's electronic social security card to advance the referral. Designated medical institutions shall promptly settle with the insured persons.

II. Settlement for medical treatment with a social security card

The settlement process remains unchanged for the insured with social security card to designated medical institutions for medical treatment.

III. Filing of Special Diseases in Outpatient ClinicsThe insured can go to the designated medical institutions to perform the filing procedures with electronic social security cards or social security cards when filing special diseases in outpatient clinics. The filing of special diseases in outpatient clinics shall take effect on the date of filing and shall become invalid after the cancellation procedures are completed. The insured who need to terminate the outpatient special disease treatment or change the outpatient special disease designated medical institution due to their medical condition shall go through the cancellation procedure at the designated outpatient special disease medical institution originally selected with social security cards or the electronic version.

This new rule will take effect starting from January 1, 2021.

Beijing Medical Insurance Affairs Management Center

December 24th, 2020