Notice on Issues Related to Real-time Settlement of External Prescriptions in Designated Retail Drugstores of Beijing Basic Medical Insurance
Designated pharmacies should keep the medical insurance private network unblocked and ensure that the insured use social security cards to settle prescription drug expenses in real time.
1. Insured personnel should take the initiative to show their social security cards when purchasing medicines from designated pharmacies with external prescriptions.
2. When the medical insurance private network is connected, the designated pharmacies download the prescription information for external use uploaded by the designated medical institutions, check that it is consistent with the prescription information for external use, fill the medicine according to the prescription information for external use, and use the social security card to settle the medical expenses for the insured, advance the expenses that should be paid by the medical insurance fund, and the rest will be paid by the insured in cash. At the same time, a charge invoice and a charge list shall be issued to the insured. If the downloaded electronic information is inconsistent with the prescription, the designated pharmacy shall verify the authenticity of the prescription with the designated medical institution.
3, designated pharmacies should keep a prescription after dispensing, and file for future reference. If a designated pharmacy cannot complete all drugs with one prescription, it shall clearly inform the insured. If the insured requests to continue dispensing, the designated pharmacy will keep the prescription after dispensing.
Extended data:
Notice on Issues Related to Real-time Settlement of External Prescriptions in Designated Retail Drugstores of Beijing Basic Medical Insurance
The insured reimburses prescription drug expenses by hand.
(a) the insured has not issued a social security card, or the social security card is lost (damaged) and applies for a replacement (replacement) of the social security card. After going to the designated medical institution for medical treatment, the prescription provided by the designated medical institution for the insured shall be signed by the doctor in duplicate and stamped with the special seal for prescription of the designated medical institution. The insured goes to the designated pharmacy to buy medicine with a prescription for external use. After the designated pharmacy fills the medicine according to the drug information of the prescription for external use, the drug expenses incurred shall be settled in full cash by the insured and the designated pharmacy, and a charge invoice and a drug list shall be issued for the insured.
(two) when the download of external prescription information is unsuccessful, the drug expenses incurred shall be settled in full cash by the insured and the designated pharmacy. After dispensing drugs according to the drug information of external prescriptions, designated pharmacies should indicate the words "download of external prescription information failed" on two external prescriptions, affix the charge stamp (or official seal) of designated pharmacies, and issue charge invoices and drug lists for the insured.
(three) designated pharmacies should keep a copy of the prescription after the full cash settlement of the drug fee, and file it for future reference. If a designated pharmacy cannot complete all drugs with one prescription, it shall clearly inform the insured. If the insured requests to continue dispensing, the designated pharmacy will keep the prescription after dispensing.
(4) If the insured's full settlement fee for purchasing drugs in designated pharmacies with prescriptions meets the relevant provisions of medical insurance, the insured shall submit relevant documents to the unit or social security office (hereinafter referred to as "social security office"), and the unit or social security office shall report to the district medical insurance agency in accordance with relevant business processes.
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Beijing Municipal Bureau of Human Resources and Social Security-Issues related to instant settlement of external prescriptions in designated retail pharmacies of medical insurance