Decision 222/QD-BHXH stipulates the announcement of replaced and abolished administrative procedures under the jurisdiction of Vietnam Social Insurance, taking effect on February 25, 2021.
Article table of contents
Procedures for direct payment of health insurance medical examination and treatment costs, issuance of Certificate of Health that not paid together during the year in Vietnam (Internet image)
According to Decision 222/QD-BHXH, Vietnam Social Insurance has provided detailed instructions on procedures for direct payment of health insurance medical examination and treatment costs and procedures for granting certificates of non-co-payment during the year, specifically as follows:
(1) Implementation sequence
Step 1: Prepare and submit the application
The patient or the patient's relative or legal representative, according to the law, shall prepare a payment request document as prescribed in Section (3) below; Submit your application directly to the social insurance agency.
Step 2: The social insurance agency receives and processes the application.
Step 3: Receive resolution results:
- In case of payment request: receive money according to the registered method when submitting the application. In cases of non-payment, a document stating the reason for non-payment from the social insurance agency.
- In case of request for Certificate without co-payment during the year, receive the Certificate. In the event that the certificate is not issued, the result will be a written response from the social insurance agency clearly stating the reason.
(2) Procedure for carrying out
*** Submit application: directly to the One-Stop Department of the social insurance agency.
*** Receive resolution results:
- For written results: through the public postal service or directly at the One-Stop Department of the social insurance agency.
- For monetary results: receive them at the Finance - Accounting Department/Division of the Social Insurance Agency.
+ The patient presents the Document Receipt Certificate and makes an appointment to return the results; an ID card.
+ In case of replacement:
- If you are a relative or guardian: present the Document Receipt Letter and make an appointment to return the results; ID card, documents proving the relationship as a relative/natural guardian of the health insurance beneficiary (copy of household registration book, birth certificate, marriage certificate, etc.);
- Other cases: present the Document Receipt Certificate and make an appointment to return the results; ID card; Power of attorney (form no. 13-HSB).
(3) Document composition
- Photocopies of the following documents (attached originals for comparison):
+ Health insurance card and one of the documents proving identity with a valid photo in case the health insurance card does not have a photo (ID card, Passport, Party member card, People's Police card, Military card, Trade union membership card, Student card, veteran card, driving license, or other valid photo document); Copy of birth certificate or birth certificate in case children under 6 years old do not have a health insurance card;
+ Hospital discharge certificate, medical examination card or medical examination book of the medical examination requested for payment
- Original copies of relevant invoices and documents.
In case of only requesting a certificate without co-payment during the year (not including direct payment of health insurance medical examination costs): Health insurance participants need to use the original invoices and receipts for other purposes. The Single-Window Department of the social insurance agency takes a photo of the Invoices and Receipts and signs and confirms the copies, then returns the originals for health insurance participants; In case the health insurance participant loses the original Invoice or Receipt then submit a photocopy of the invoice or receipt certified by the medical examination and treatment facility where the health insurance card holder receives medical examination and treatment, or the List of medical examination and treatment expenses (according to Form No. 01/BV, 02/BV).
Number of documents: 01 set
(4) Processing time limit:
- At least 40 days from the date the social insurance agency receives complete documents.
- In case of issuance of Certificate, payment is not made during the year. The processing time is as follows:
+ 01 working day from the date of receiving complete documents according to regulations in case the health insurance participant has the process of participating in health insurance in only one province or the health insurance card has the time of participating in health insurance continuously for full 05 years.
+ 03 working days from the date of receipt of complete documents according to regulations. In cases where health insurance participants submit complete documents but have time to participate in health insurance outside the province, the health insurance card does not record the time of continuous health insurance participation for the full 05 years.
+ 05 working days from the date of receipt of complete documents according to regulations for cases where health insurance participants submit complete documents but only examine and treat diseases within the province, the receipt and invoice do not clearly show the patient's co-payment amount, or health insurance participants submit photocopies of invoices, receipts, and lists of medical examination and treatment expenses according to Forms 01/BV and 02/BV.
+ 10 working days from the date of receipt of complete documents according to regulations. In cases where health insurance participants submit complete documents and have medical examination and treatment outside the province, the receipt and invoice do not clearly show the amount of money paid by the patient, or health insurance participants submit photocopies of invoices, receipts, and lists of medical examination and treatment expenses according to Forms 01/BV and 02/BV.
- Key word:
- Vietnam Social Insurance
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