員(yuán)工(gōng)服務
— Staff services—
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醫療費報銷
時間： 2020-12-16
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<strong><span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">一(yī)、受理時間</span></strong>
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<span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">醫療（配置）終結30日内到市工(gōng)傷保險經辦機構辦理工(gōng)傷（亡）保險待遇審核手續。</span>
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<strong><span style="font-size:14px;font-family:arial, helvetica, sans-serif;line-height:150%;">二、所需資(zī)料</span></strong>
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<span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">（除發票、費用清單以外(wài)所有材料請準備一(yī)份複印件）</span>
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<span style="font-family:arial, helvetica, sans-serif;font-size:14px;">1、工(gōng)傷認定書原件及複印件；</span>
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<span style="font-family:arial, helvetica, sans-serif;font-size:14px;">2、醫療費原始發票</span>
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<span style="font-family:arial, helvetica, sans-serif;font-size:20px;"><span style="font-size:14px;">3、門診病曆、門診藥品清單、門診放(fàng)射、CT診斷報告單、出院小(xiǎo)結原件及複印件（</span><span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">若員(yuán)工(gōng)已報商(shāng)保，無法提供這幾項原件，需提供複印件加蓋商(shāng)保章并且提供商(shāng)保結算單</span><span style="font-size:14px;">）； </span></span>
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<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>
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<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(gōng)傷醫療（康複）待遇申報表</span><span style="font-size:14px;">》【本頁可下(xià)載】</span></span><span style="font-size:14px;">加蓋單位公章；</span></span>
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<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确認材料；</span></span>
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<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複印件；</span></span>
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<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複印件等相關材料；</span></span>
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<span style="font-family:arial, helvetica, sans-serif;font-size:14px;color:#FF0000;">（1）若交通事故中(zhōng)肇事者未被抓獲，在報銷時還需單位提供的“單位承諾書”承諾内容：肇事者未被抓獲、先由基金墊付工(gōng)傷費用，後期如果肇事者抓獲将退還墊付費用。</span>
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<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(gōng)傷報銷，需要到交警大(dà)隊開(kāi)交通事故認定書，下(xià)面說明責任情況和賠付情況。對于已經鑒定勞動能力的員(yuán)工(gōng)，其傷殘補助金等費用也是差額賠付。</span>
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<span style="font-family:arial, helvetica, sans-serif;font-size:14px;">9、工(gōng)傷康複的确認證明；（需要到老社保局辦理《康複認定書》）</span>
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<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複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(zī)料等。</span></span>
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<strong><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">三、注意事項</span></strong>
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<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(yī)緻；</span></span>
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<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;">挂号費、發票必須蓋章；</span></span>
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<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曆的醫囑；</span></span>
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<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(xiǎo)結；</span></span>
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<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>
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<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>
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<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(yī)次性費用目錄。</span></span>
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<strong><span style="font-family:arial, helvetica, sans-serif;font-size:14px;">【涉及的模闆如下(xià)，請下(xià)載使用】</span></strong>
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<span style="font-size:14px;"> </span><a href="/ueditor/php/upload/file/20201216/1608102644747424.doc"><strong><span style="font-size:14px;">合肥市工(gōng)傷醫療（康複）待遇申報表.doc</span></strong></a>
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