What documents are included in health insurance-covered service contracts in Vietnam? What is the validity period of the contracts?
- What documents are included in health insurance-covered service contracts in Vietnam?
- What are the requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract?
- What is the validity period of health insurance-covered service contracts for the first time?
What documents are included in health insurance-covered service contracts in Vietnam?
Pursuant to Article 16 of Decree No. 146/2018/ND-CP stipulating insurance-covered service contracts as follows:
Health insurance-covered service contracts in Vietnam
1. In case of a first-time health insurance-covered service contract, documents shall include:
a) Request form for signing the contract, prepared by the requesting healthcare establishment;
b) Duplicate of the healthcare license, issued by a competent regulatory authority to the requesting healthcare establishment;
c) Internally stamped duplicate of the decision on ranking of hospitals made by a competent regulatory authority (if any) or the decision on medical level issued by a competent regulatory authority with respect to non-public healthcare establishments;
d) List of medical technology services, medicines, chemicals or medical supplies, approved by a competent regulatory authority (whether in the written or electronic form).
Thus, in case of a first-time health insurance-covered service contract, documents shall include:
- Request form for signing the contract, prepared by the requesting healthcare establishment;
- Duplicate of the healthcare license, issued by a competent regulatory authority to the requesting healthcare establishment;
- Internally stamped duplicate of the decision on ranking of hospitals made by a competent regulatory authority (if any) or the decision on medical level issued by a competent regulatory authority with respect to non-public healthcare establishments;
- List of medical technology services, medicines, chemicals or medical supplies, approved by a competent regulatory authority (whether in the written or electronic form).
What documents are included in health insurance-covered service contracts in Vietnam? What is the validity period of the contracts?
What are the requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract?
Pursuant to Clause 2, Article 17 of Decree No. 146/2018/ND-CP stipulating the requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract as follows:
Contractual terms and conditions, requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract with
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2. Requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract shall be comprised of the followings:
a) Fully meet requirements for conformance to medical practicing regulations in accordance with laws on healthcare services and have obtained a competent regulatory authority’s medical service license;
b) Ensure provision of medicines, chemicals and medical supplies are in line with the scope of functions of that healthcare establishment.
Thus, the requirements for eligibility of a healthcare establishment for signing a health insurance-covered service contract shall be comprised of the followings:
- Fully meet requirements for conformance to medical practicing regulations in accordance with laws on healthcare services and have obtained a competent regulatory authority’s medical service license;
- Ensure provision of medicines, chemicals and medical supplies are in line with the scope of functions of that healthcare establishment.
What is the validity period of health insurance-covered service contracts for the first time?
According to the provisions of Clause 2, Article 18 of Decree No. 146/2018/ND-CP as follows:
Conclusion of health insurance-covered service contracts
1. In case of entering into a health insurance-covered service contract for the first time:
a) A healthcare establishment sends 01 set of documents referred to in Article 16 hereof to a social insurance agency;
b) Within duration of 30 days of receipt of all required documents (based on the postmark date of received document), a social insurance agency must complete the processing of submitted documents and contract signing. In case of refusal to sign a health insurance-covered service contract, a written response clearly stating reasons for such refusal must be sent.
2. Validity period of a health insurance-covered service contract:
a) The validity period of a contract shall range from January 1 to end of December 31 of each year, but shall be restricted to 36 months;
b) In case of the health insurance-covered service contract signed for the first time, the validity period of this contract shall start from the signature date to end of December 31 in the year on which the contract expires, but shall not exceed 36 months;
c) In case of signing a health insurance-covered service contract on an annual basis, a healthcare establishment and a social insurance agency shall completely conclude the contract of the following year before December 31 of that year.
10 days before the contract expires, if the healthcare establishment and the social insurance agency agree on the contract extension and negotiate about the implementation of the contract based on an appendix to that contract, that appendix shall have legal value, unless otherwise agreed upon.
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Thus, the validity period of a contract shall range from January 1 to end of December 31 of each year, but shall be restricted to 36 months.
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