Notice of the General Office of Nansha District People's Government of Guangzhou Municipality on Issuing the Medical Assistance Scheme for secondary reimbursement in Nansha District of Guangzhou Municipality

Reimbursement scope for Class-II Special Diseases for Outpatient Treatment: Refer to the scope of assistance for Class-II Special Diseases for Outpatient Treatment as specified in the Notice of Bureau of Healthcare Security of Guangzhou Municipality, Bureau of Finance of Guangzhou Municipality, Health Commission of Guangzhou Municipality on Issuing the Scope and Standards of Outpatient Payment for Specific Diseases with Overall Plan Funds for Social Medical Insurance in Guangzhou (Normative Document No 4 [2019] of the Bureau of Healthcare Security of Guangzhou Municipality). This reimbursement scope shall be changed accordingly with the adjustment of medical insurance policies.

(IV) Reimbursement Standards for Physical Examination

During the insurance period, physical exams at a designated hospital shall be covered for participants aged over 40, with a maximum reimbursement amount of 100 yuan per person per year.

The physical exam costs can be settled in the form of "Internet +", that is, on the basis of Internet medical services, cooperation between online medical services and offline designated hospitals in Nansha district shall be promoted to give full play to the effective division of labor between them, so as to realize the integration of online and offline medical services. The part of physical exam costs covered by secondary reimbursement insurance may be paid by the online hospitals first, and the designated hospitals in Nansha district shall proceed with the physical exams; operators shall settle the payments within 10 working days after receiving and verifying the settlement statement from online hospitals every month.

VII. Reimbursement Methods

Secondary reimbursement methods are divided into one-stop real-time settlement and sporadic reimbursement. In principle, the medical expenses incurred by participants in a designated hospital in Nansha district shall be subject to one-stop real-time settlement, and secondary reimbursement part shall be exempted on credit; if the one-stop real-time settlement fails due to treatment outside the region, network failure, or other reasons, the medical expenses incurred by the participant in the hospital may be reimbursed sporadically.