GB/T 48018-2026 基本医疗保险登记服务规范

ICS03.060

CCSA11

中华人民共和国国家标准

GB/T48018—2026

基本医疗保险登记服务规范

Specificationforbasicmedicalinsuranceregistrationservice

2026⁃07⁃30发布2026⁃09⁃01实施

国家市场监督管理总局

国家标准化管理委员会发布

GB/T48018—2026

目次

前言··························································································································Ⅲ

1范围·······················································································································1

2规范性引用文件········································································································1

3术语和定义··············································································································1

4基本要求·················································································································2

5服务内容、方式和流程································································································2

6业务档案管理·········································································································12

7经办风险控制·········································································································13

8服务监督、评价和改进·······························································································13

附录A（资料性）业务表单···························································································14

参考文献····················································································································21

Ⅰ

GB/T48018—2026

前言

本文件按照GB/T1.1—2020《标准化工作导则第1部分：标准化文件的结构和起草规则》的规定

起草。

请注意本文件的某些内容可能涉及专利。本文件的发布机构不承担识别专利的责任。

本文件由国家医疗保障局提出。

本文件由全国医疗保障标准化工作组（SAC/SWG37）归口。

本文件起草单位：国家医疗保障局、中国社会保障学会。

本文件主要起草人：李滔、樊卫东、许静、张海燕、彭康康、余丞臻、韩宗钊、史康健、柳雯馨、王亚萍、

严娟、周剑、马丽、翟梦媛、张捷、张圣和。

Ⅲ

GB/T48018—2026

基本医疗保险登记服务规范

1范围

本文件规定了基本医疗保险登记服务的基本要求，服务内容和方式、业务档案管理、经办风险控

制，服务监督、评价和改进，并确立了服务流程。

本文件适用于医疗保障（社会保险）经办机构和经授权的其他服务机构开展基本医疗保险登记

工作。

2规范性引用文件

下列文件中的内容通过文中的规范性引用而构成本文件必不可少的条款。其中，注日期的引用文

件，仅该日期对应的版本适用于本文件；不注日期的引用文件，其最新版本（包括所有的修改单）适用于

本文件。

GB/T19038顾客满意测评模型和方法指南

GB/T19039顾客满意测评通则

GB/T31596.1社会保险术语第1部分：通用

GB/T31596.4社会保险术语第4部分：医疗保险

GB/T31596.6社会保险术语第6部分：生育保险

GB/T31599社会保险业务档案管理规范

3术语和定义

GB/T31596.1、GB/T31596.4、GB/T31596.6界定的以及下列术语和定义适用于本文件。

3.1

基本医疗保险登记basicmedicalinsuranceregistration

用人单位（个人）按规定提交或通过与其他管理机关数据共享得到的参保信息，经当地医疗保障经

办机构审核确定建立、变更基本医疗保险关系的行为。

注：参保登记含新参保登记、暂停参保登记、注销登记等相关内容。险种包括职工基本医疗保险、城乡居民基本医

疗保险、生育保险、城乡居民大病保险、职工大额医疗费用补助等。

[来源：GB/T31596.1—2015，3.7，有修改]

3.2

基本医疗保险联办登记registrationthroughinformationsharinginbasicmedicalinsurance

用人单位或个人在其他管理机关办理登记时，医疗保障经办机构通过数据共享方式同步办理基本

医疗保险登记的行为。

3.3

基本医疗保险关系转移接续basicmedicalinsurancerelationshipistransferredandcontinued

参保人员因跨统筹地区就业、户籍或常住地变动时，按规定办理基本医疗保险关系转移接续，包括

个人医保信息记录的传递、职工医保个人账户资金的转移和医疗保险待遇衔接的处理。

[来源：GB/T31596.1—2015，3.8.4，有修改]

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