2023 is the fifth year after Shanghai launched the reform of government services on Government Online-Offline Shanghai. The Leading Group for Government Online-Offline Shanghai of Yangpu District, the Publicity Department of the CPC Yangpu District Committee and Yangpu District Integrated Media Center jointly released a series of reports on the fifth anniversary of Government Online-Offline Shanghai with a focus on changes in Yangpu District’s government service channels to demonstrate the convenience brought about by the reform.

To improve the quality and efficiency of medical insurance services, complete the priorities of the reform of Government Online-Offline Shanghai and allow people to get things done in one trip, the Medical Insurance Bureau of Yangpu District launched the Rainbow Medical Insurance Protection Program, with the goal of improving people’s satisfaction level. It pays equal attention to service and management, combines innovation with inheritance and takes into account both priorities and routines. It has promoted Government Online-Offline Shanghai in many matters such as maternity insurance and medical assistance, deepened the reform of government services in an all-round way, improved the level of medical insurance services and made every effort to safeguard Yangpu people’s livelihood.

Handling maternity insurance completely online to tamp the foundation for convenience services

Recently, Ms. Wang uploaded photos when applying for maternity benefits online. She thought it was finished, so she left the vouchers for hospitalization in her hometown. When handling her application, the clerk found that photos of her ID card and the Fertility Medical Certificate uploaded by her were blurry and that key information about her delivery could not be verified, so the clerk got in touch with her and informed her of these problems. Ms. Wang thought she needed to go back to her hometown to get the vouchers, which made her concerned.

After the clerk’s patient explanation, she was surprised to learn that the process could be completed by obtaining electronic certificates. “It’s so convenient to go through the whole process online! It takes most of a mother’s time to take care of her baby. We can complete the application for maternity benefits without leaving home, which relieves our worries!”

Ms. Wen’s family members live in another city. To take better care of her baby, she quit her job in Shanghai after labor and returned to her hometown. As the payment base reported by her new company was lowered, Ms. Wen needed to return the extra money according to the annual liquidation requirements of Shanghai Medical Insurance Center. Due to system limitations, the refund needed to be handled at a district-level medical insurance center, which was inconvenient to Ms. Wen because she no longer lived in Shanghai. “I know it’s wrong not to return the money, but it’s really inconvenient for me to go to Shanghai for a few hundred yuan. I’ll have to find time to get it done,” she said.

Thanks to the joint efforts of several government agencies, the online system of maternity insurance services was upgraded in 2023 so that the refund could be completed on the Suishenban app. After learning the news, Ms. Wen immediately completed the refund operation on the app.

Maternity insurance application was transferred from the social insurance field to the medical insurance field from January 1, 2021. To make it more convenient for pregnant women to apply for maternity benefits, the Medical Insurance Bureau of Yangpu District continuously explores socialized application of electronic certificates and licenses on Government Online-Offline Shanghai according to municipal requirements and facilitates the use of electronic certificates and licenses with big data platforms, converting offline acceptance to online acceptance. In 2023, the online system for maternity insurance in this matter was upgraded for the convenience of mothers who are out of town or busy with work, while ensuring the reasonable use of medical insurance funds to the greatest extent.

Recently, the Bureau optimized the online certificate supplement function in response to situations where insured persons have left out materials or uploaded wrong materials to tamp the foundation for convenience services for the people. Since 2021, more than 20,000 people have applied for maternity benefits in Yangpu District, with a total payment of more than 900 million yuan. Currently, 99% of applications for maternity benefits are completed online. Applicants can complete the entire process at the Yangpu Channel of Government Online-Offline Shanghai and the Yangpu Flagship Store on Suishenban Citizen Cloud without leaving home.

Medical assistance enjoyed by disadvantaged groups without application

Ms. Xu is a subsistence allowance recipient suffering from ankylosing spondylitis. She spends a lot of money on medical services. In the past, she had to go to the reception center of the sub-district of her registered residence to apply for medical assistance almost every month. At the end of 2022, the neighborhood committee informed her that an online platform for medical assistance that enabled “enjoyment without application” would be launched. After signing the papers, insured persons can apply for medical assistance on the platform instead of taking the invoices, medical records and other materials to an acceptance center, which is very convenient.

Ms. Xu signed the papers on January 31, 2023. Now, the platform automatically gets her medical expenses incurred at medical institutions designated by medical insurance authorities. A sub-district clerk accepts, reviews and approves her application online. After the district-level medical insurance center reviews the amount of medical assistance, the money is transferred directly to her bank account.

Mr. Xu is a subsistence allowance recipient who has suffered from uremia for more than ten years. He has a physically disabled wife and a daughter who is in school. To get medical assistance, he went to the insurance company to submit critical illness materials for residential insurance, went there for a second time to get the critical illness settlement sheet and then went to the Community Affairs Center to submit the settlement sheet and medical invoices every two months. It took him three hours each time, which was a great burden to his frail body. At the end of 2022, he learned from the neighborhood committee that the online “enjoyment without application” platform for medical assistance would be launched. He signed the application notification and the letter of commitment on November 8, 2022.

Starting from January 1, 2023, the process of Mr. Xu’s application for medical assistance has been reduced from three steps to one. The medical expenses incurred only need to be sent to the insurance company closest to his home. The medical expenses incurred at medical institutions designated by medical insurance authorities and the settlement data shared by the insurance company can be viewed on the platform. A sub-district clerk accepts, reviews and approves Mr. Xu’s application online. After being approved by the district-level medical insurance center, the medical assistance fund will be directly transferred to his bank account.

Since 2019, medical assistance has been managed by local authorities. Although there was a one-stop system for reimbursement of medical expenses, online real-time assistance for Yangpu residents could only be provided when they were incurred at designated medical institutions in the district. If the medical expenses were incurred in other districts, the recipients had to take relevant materials to the sub-districts of their registered residences to get the matter handled.

For recipients’ convenience, the Medical Insurance Bureau of Yangpu District built an online processing system in 2022 to achieve the goal of “enjoyment without application, acceptance without bills and receiving without trips.” The system is connected to real-time settlement data of the municipal medical insurance center. Medical expenses incurred at designated medical institutions in Shanghai can be viewed in the system. Since the launch of the system in January 2023, medical assistance has been paid online to a total of more than 70,000 people, with a total payment of more than 18 million yuan.

Over the past five years, Yangpu District has always adhered to the concept of “a people’s city for the people” and regarded the expectations of enterprises and the people as the goal and direction of the reform of Government Online-Offline Shanghai. The next issue will present the results of the Human Resources and Social Security Bureau of Yangpu District and the changes in Yangpu District’s government services in more detail.