Vietnam: Guidelines for Circular 30/2020/TT-BYT on medical examination and treatment covered by health insurance

In order to unify in the organization of implementation, Vietnam Social Security requests social insurance provinces to study the contents specified in Circular 30/2020/TT-BYT and note some contents about medical examination and treatment with health insurance in the bordering communes of the bordering province as follows:

- The social insurance of provinces shall base itself on the list of health stations at the commune level with administrative boundaries directly adjacent to the communes of another province provided by the provincial Departments of Health after reaching agreement with the Departments of Health of the neighboring provinces as specified at Point b, Clause 3, Article 14 of Circular 30/2020/TT-BYT (in writing) to make payment for medical and health care costs with health insurance in the commune at the border of the neighboring province in accordance with the provisions of Clause 4, Article 14 of Decree 146/2018/ND-CP;

- Persons with health insurance cards who register for initial medical treatment at commune health stations and the equivalent for medical treatment at CHSs of neighboring communes of other provinces are cases of medical treatment not on the right route but are entitled to 100% of medical expenses within the scope and level of benefits specified in Clause 1, Article 14 of Decree 146/2018/ND-CP;

- Encryption of data and recording of KCB expenses is as follows:

• In field No. 16 (MA_LYDO_VVIEN) of Table 1 issued together with Vietnam's Decision 4210/QD-BYT 2017 on output data format and standards for management, assessment and payment of medical and health care costs under health insurance, write code 3;

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  In field No. 17 (MUC_HUONG) of Table 2, Table 3 was issued together with Vietnam's Decision 4210/QD-BYT: at a rate of 100

More details can be found in Vietnam's Official Dispatch 561/BHXH-CSYT, issued on March 10, 2021.

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