員工服務
— Staff services—
醫療費報銷
時間: 2020-12-16
<p style="text-indent:21px;"> <strong><span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">一、受理時間</span></strong> </p> <p style="text-indent:21px;"> <span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">醫療(配置)終結30日內到市工傷保險經辦機構辦理工傷(亡)保險待遇審核手續。</span> </p> <p style="text-indent:21px;"> <span style="font-size:20px;font-family:arial, helvetica, sans-serif;line-height:150%;"><br /> </span> </p> <p style="text-indent:21px;"> <strong><span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">二、所需資料</span></strong> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">(除發票、費用清單以外所有材料請準備一份復印件)</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;">1、工傷認定書原件及復印件;</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;">2、醫療費原始發票</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-size:14px;">3、門診病歷、門診藥品清單、門診放射、CT診斷報告單、出院小結原件及復印件(</span><span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">若員工已報商保,無法提供這幾項原件,需提供復印件加蓋商保章并且提供商保結算單</span><span style="font-size:14px;">);&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">4、</span><span style="font-size:14px;">費用清單;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-size:14px;">5、《</span><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">合肥市工傷醫療(康復)待遇申報表</span><span style="font-size:14px;">》【本頁可下載】</span></span><span style="font-size:14px;">加蓋單位公章;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">6、</span><span style="font-size:14px;">輔助器具費原始發票及醫囑確認材料;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">7、</span><span style="font-size:14px;">勞動能力鑒定費發票及鑒定結論復印件;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">8、</span><span style="font-size:14px;">民事賠償法律文書及事故認定書原件及復印件等相關材料;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">(1)若交通事故中肇事者未被抓獲,在報銷時還需單位提供的“單位承諾書”承諾內容:肇事者未被抓獲、先由基金墊付工傷費用,后期如果肇事者抓獲將退還墊付費用。</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">(2)如果對方賠錢,還要申請工傷報銷,需要到交警大隊開交通事故認定書,下面說明責任情況和賠付情況。對于已經鑒定勞動能力的員工,其傷殘補助金等費用也是差額賠付。</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:14px;">9、工傷康復的確認證明;(需要到老社保局辦理《康復認定書》)</span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">10、</span><span style="font-size:14px;">協議醫療機構或者協議康復機構按照規定出具的診斷證明、費用單據、費用清單和相關病案資料等。</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><br /> </span> </p> <p style="text-indent:21px;"> <strong><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">三、注意事項</span></strong> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">1、</span><span style="font-size:14px;">發票姓名必須與身份證上的一致;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">2、</span><span style="font-size:14px;">掛號費、發票必須蓋章;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">3、</span><span style="font-size:14px;">門診發票須有當日門診病歷的醫囑;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">4、</span><span style="font-size:14px;">住院發票須有出院小結;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">5、</span><span style="font-size:14px;">門診藥費須有對應的藥品明細;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">6、</span><span style="font-size:14px;">攝影、CT、MRI需要提供檢查報告單;</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">7、</span><span style="font-size:14px;">一次性費用目錄。</span></span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><br /> </span> </p> <p style="text-indent:21px;"> <span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><br /> </span> </p> <p style="text-indent:21px;"> <strong><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">【涉及的模板如下,請下載使用】</span></strong> </p> <p> <span style="font-size:14px;">&nbsp; &nbsp; &nbsp;&nbsp;</span> </p> <p> <span style="font-size:14px;">&nbsp; &nbsp; &nbsp; &nbsp;</span><a href="/ueditor/php/upload/file/20201216/1608102644747424.doc"><strong><span style="font-size:14px;">合肥市工傷醫療(康復)待遇申報表.doc</span></strong></a> </p> <p> <br /> </p>
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