Guidelines on Resolving Health Insurance Benefits When Patients are Referred to Another Health Facility

17:20, 10/07/2024

Vietnam Social Security recently issued Official Dispatch 1155/BHXH-CSYT on resolving health insurance benefits for patients referred to higher-level hospitals.

When receiving patients with health insurance cards in cases of being referred to higher-level facilities as stipulated in Clause 3, Article 14 Decree 146/2018/ND-CP, the receiving facility must check the patient's medical history to obtain information as a basis for resolving the patient's entitlements.

In cases where the patient's medical history is not available at the referring medical facility, the health insurance referral document must still be used as the basis for resolving the patient's entitlements.

Receiving medical facilities that refuse to resolve the health insurance benefits or ask patients to return to the referring medical facility to confirm the benefit level at the hospital are in violation of the law.

Details can be found in Official Dispatch 1155/BHXH-CSYT, issued on April 11, 2019.

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