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20
11110105MB1865700E
北京市朝阳区医疗保障局
城乡居民异地长期居住备案
11110105MB1865700E311204104500301
11110105MB1865700E3112041045003
0
38e068a2-a707-4fb5-8858-8458df33d71f
46142f18-4031-40b3-b3f8-4cfc8f1e241d
3^5
20
朝阳区医保局
110105000000
北京市朝阳区医疗保障局
朝阳区政务服务中心医保分中心:法定工作日: 上午: 09:00 - 12:00; 下午: 13:30 - 17:00; (延时服务时间: 工作日上午08:30 - 09:00; 下午17:00 - 17:30; 周六上午08:30 - 12:30; );朝阳区政务服务中心:法定工作日: 上午: 09:00 - 12:00; 下午: 13:30 - 17:00; (延时服务时间: 工作日上午08:00 - 09:00; 中午12:00 - 13:30; 下午17:00 - 18:00; 周六上午09:00 - 11:30; 下午13:30 - 16:30; )
朝阳区政务服务中心医保分中心:北京市朝阳区建国路世通国际大厦E座8层3号窗口
朝阳区政务服务中心:北京市朝阳区霄云路霄云里1号二层综合窗口
1.本市参保人员有跨省异地就医需求时均可申请办理跨省异地就医备案，办理备案时，需提交《北京市跨省异地就医登记备案表》，如实登记本人信息，并签署《基本医疗保险跨省异地就医备案个人承诺书》，承诺保证本人符合办理条件，所述（填）信息真实、准确、完整、有效，愿意接受信息共享查询核验，由此产生的一切经济损失和法律责任均由本人承担即可备案。（来源《北京市医疗保障局关于进一步做好基本医疗保险跨省异地就医直接结算工作的通知》（京医保发〔2022〕41号）。
2.材料齐全，填写完整，按要求签字。
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