Payment procedures for health insurance after hospital discharge
Tue, 19 Feb 2019 11:25:00 | Print | Email Share:
(Chinhphu.vn) - Ms. Le Thi Nguyen (in Ho Chi Minh City) gave birth to a premature baby. When she went to the hospital, she did not bring her health insurance card. At present, Mrs. Nguyen has been discharged from the hospital and paid her own hospital fees. All hospital bills have information ofher company. Ms. Nguyen would like to ask, isshe paidback the hospital fee? If so, howis procedure?
Regarding to this issue, Ho Chi Minh Social Insurance responds as follows:
Mrs. Nguyen's case will be paid for medical examination and treatment expenses in accordance with Article 14 of the Joint Circular No. 41/2014 / TTLT-BYT-BTC. Accordingly, the application file for payment includes: Request for payment of medical examination and treatment costs for health insurance established by Vietnam Social Insurance; the health insurance card (valid during the time of medical examination and treatment), ID photo; hospital discharges’ originals of valid documents (drug receipts, hospital receipts and related documents).
The patient or relative of the patient is responsible for submitting the documents stipulated in Article 15 of the above Circular to the district-level social insurance prior to 31 March 2018.
Regarding the health insurance payment rate, in case patients come to medical examination and treatment at health facilities, there are contracts of medical examination and treatment with health insurance: Payment within the scope of benefits and health insurance coverage according to regulations:
-At the central hospital is 40% of the cost of inpatient treatment;
- At the provincial hospital, 60% of the cost of inpatient treatment;
- At the district hospital, 100% of medical examination and treatment costs
In case patients come to medical examination and treatment at health facilities without medical examination and treatment contracts for health insurance: Payment according to actual costs within the scope of benefits and the level of health insurance but not exceeding the prescribed level defined in Appendix 04 issued together with the above Circular.
Types of medical examination and treatment |
Technical professionalline |
The maximum payment for a medical examination and treatment (VND) |
In-patient |
Health facilities at district and equivalent levels |
500.000 |
Provincial and equivalent medical facilities |
1.200.000 |
|
Health facilities at central and equivalent levels |
3.600.000 |
By: Online Newspaper of the Government / Translator: HaiYen-Bizic
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