1、 Check whether the items are included in the reimbursement scope of Guangzhou medical insurance
As a top ophthalmic hospital in Guangzhou, Sun Yat sen University Ophthalmology Department provides comprehensive ophthalmic examination services. However, not all ophthalmic examination items meet the reimbursement requirements of Guangzhou Medical Insurance. Guangzhou Medical Insurance has strict reimbursement requirements for ophthalmic examinations, and only those items that meet the specified scope can be reimbursed. According to the catalogue of Guangzhou medical insurance regulations, let's see whether the common ophthalmic examination items of Sun Yat sen University meet the reimbursement requirements of Guangzhou medical insurance.
First of all, common ophthalmic examination items include fundus examination, intraocular pressure measurement, vision test, etc. These projects are the basic examination projects of the ophthalmology department of Sun Yat sen University, and also the projects supported by Guangzhou Medical Insurance Institute. Therefore, these items can meet the reimbursement requirements of Guangzhou Medical Insurance when they are examined in the ophthalmology department of Sun Yat sen University.
Secondly, some special ophthalmic examination items, such as corneal topography examination, visual field examination, tear secretion examination, etc., are not clearly listed in the catalogue of Guangzhou medical insurance. Therefore, if the patient performs these examinations in the ophthalmology department of Sun Yat sen University, he may not enjoy the reimbursement policy of Guangzhou Medical Insurance.
Finally, it should be noted that some unconventional ophthalmic examination items, such as laser treatment and vitreous surgery, are not included in the reimbursement scope of Guangzhou medical insurance. If the patient carries out the examination or treatment of these items, they need to pay at their own expense.
2、 Whether the hospital has signed a contract with Guangzhou medical insurance
In addition to whether the ophthalmic examination project itself meets the requirements of Guangzhou medical insurance, the contractual relationship between the hospital and Guangzhou medical insurance is also the key to decide whether to enjoy medical insurance reimbursement. Only hospitals contracted with Guangzhou Medical Insurance can provide patients with Guangzhou medical insurance reimbursement services.
As a top ophthalmic hospital, Sun Yat sen University has a close cooperation relationship with Guangzhou medical insurance. The hospital signed a contract with Guangzhou Medical Insurance to provide reimbursement services for patients. Therefore, the patients can enjoy the reimbursement policy of Guangzhou medical insurance when they have eye examinations in the Department of Ophthalmology of Sun Yat sen University.
3、 Medical insurance reimbursement proportion and reimbursement limit
In addition to the contracted relationship between the ophthalmic examination project and the hospital, the reimbursement ratio and reimbursement limit of Guangzhou medical insurance are also factors to be considered.
According to the regulations of Guangzhou medical insurance, the reimbursement ratio of ophthalmic examination items is 50% to 90%, depending on different items. The reimbursement limit is generally a certain proportion of the self paid drugs, materials and other expenses for each visit. Therefore, patients can enjoy a certain proportion of expense reimbursement when they are examined in the ophthalmology department of Sun Yat sen University.
4、 How to handle medical insurance reimbursement procedures
After confirming that the ophthalmic examination items of Sun Yat sen University meet the reimbursement requirements of Guangzhou medical insurance, patients also need to know how to handle medical insurance reimbursement procedures.
Patients need to carry their medical insurance card, ID card and other relevant documents when they go to see a doctor. At the end of the visit, the patient can go through the reimbursement procedures at the medical insurance window of the hospital. The hospital staff will help to handle the medical insurance reimbursement procedures according to the patient's situation, and directly settle or reimburse the expenses to the patient.
In a word, the ophthalmic examination items of Sun Yat sen University can meet the reimbursement requirements of Guangzhou Medical Insurance under certain circumstances. In addition to paying attention to whether the inspection items meet the requirements of Guangzhou medical insurance, patients also need to understand the contract relationship between the hospital and Guangzhou medical insurance, reimbursement ratio and reimbursement limit, and how to handle medical insurance reimbursement procedures to ensure that they can enjoy the reimbursement policy of Guangzhou medical insurance.
