Power to sign the slip of referrals in medical examination and treatment covered by health insurance in Vietnam

Power to sign the slip of referrals in medical examination and treatment covered by health insurance in Vietnam (Internet image)

Regarding this issue, LawNet would like to answer as follows:

1. Appropriate referrals in medical examination and treatment covered by health insurance in Vietnam

Appropriate referrals in medical examination and treatment covered by health insurance in Vietnam according to Article 11 of Circular 40/2015/TT-BYT (amended in Decree 146/2018/ND-CP) are as follows:

- Each holder of health insurance card who registered for initial medical services at health facilities of communes or polyclinics or hospital of districts may get medical services at health stations of communes, polyclinics or hospitals of districts in the same province.

- Each holder of health insurance card who registered for initial medical services at a health facility of commune may take a referral to a hospital of district, including grade I, II hospitals of district and hospitals of traditional medicine of province (if the hospital of district has no department of traditional medicine).

- Each holder of health insurance card may take a referral from a hospital of district, including grade I, grade II hospital and polyclinic hospital, specialized hospital, specialized institute, specialized center of province, to a specialized center of province or polyclinic hospital, specialized hospital, specialized institute of province at the same level or lower level.

- Emergency cases:

+ A patient shall be given emergency treatment at any health facilities. The doctor or physician assistant receiving the patient shall assess the emergency conditions and record in medical record.

+ After emergency treatment, the patient shall be admitted as an inpatient to the receiving facility or referred to another health facility for continuing treatment at the specialist requirements or referred to the original facility upon his/her rehabilitation.

- In case the referred patient has another disease already, or a disease that is diagnosed apart from the disease specified in the outward referral form, the receiving facility shall give treatment to those diseases within its capacity.

2. Conditions for referrals in medical examination and treatment covered by health insurance in Vietnam

Conditions for referrals in medical examination and treatment covered by health insurance in Vietnam according to Article 5 of Circular 14/2014/TT-BYT are as follows:

- The medical facility shall transfer a patient to a superior facility if the following conditions are satisfied:

+ The disease is not suitable to the capacity in diagnosis and treatment and the list of techniques of the medical facility approved by a regulatory authority in healthcare or, the disease is suitable to the capacity in diagnosis and treatment and the list of techniques of the medical facility approved by a regulatory authority in healthcare but, due to an objective reason, such medical facility is not qualified to provide diagnosis and treatment;

+ Depending on the list of techniques approved by a regulatory authority in healthcare, if the directly superior facility does not have suitable medical techniques, patients shall be transferred to a higher-rank facility;

+ Before the patient is transferred, a medical consultation shall be held to appoint the receiving facility (excluding rank 4 clinics and medical facilities).

- A medical facility may transfer the patient to a suitable inferior facility if the patient is diagnosed no longer in emergency conditions and the disease has eased up and suitable for receiving treatment from an inferior facility.

- Conditions for transfer of patients between medical facilities of the same level:

+ The disease is not suitable to the list of techniques of the medical facility approved by a regulatory authority in healthcare or, the disease is suitable to the list of techniques of the medical facility approved by a regulatory authority in healthcare but, due to an objective reason, such medical facility is not qualified to provided diagnosis and treatment;

+ The disease is suitable to the list of techniques of the medical facility that is planned to receive the patient that is approved by a regulatory authority.

- Transfer between medical facilities in neighboring areas to ensure good conditions for patients:

+ Directors of Departments of Health of provinces shall detail the transfer between medical facilities in neighboring areas in central-affiliated cities and provinces within their management;

+ Directors of Departments of Health of provinces shall cooperate with each other in guiding the transfer between medical facilities in neighboring areas in central-affiliated cities and provinces within their management;

- The transfers of patients according to regulations in clauses 1, 2, 3 and 4 of Article 5 of Circular 14/2014/TT-BYT are considered on-line transfer. The transfers of patients uncomfortable with regulations in clauses 1, 2, 3 and 4 of Article 5 of Circular 14/2014/TT-BYT are considered off-line transfer

If the patient does not satisfy the conditions for transfer of facilities specified in clauses 1, 2, 3 and 4 of Article 5 of Circular 14/2014/TT-BYT but he/she or his/her legal representative requests the transfer, the medical facility shall carry out the transfer procedures to ensure the right of choosing medical facility of the patient.

The transferring facility shall provide the patient with information about the rights and charge of medical treatment after deducting the amount covered by medical insurance when receiving off-line treatment.

3. Power to sign the slip of referrals in medical examination and treatment covered by health insurance in Vietnam

Power to sign the slip of referrals in medical examination and treatment covered by health insurance according to Article 6 of Circular 14/2014/TT-BYT is as follows:

- Regarding public medical facilities: the Head of the medical facility or the person authorized by the Head of the medical facility is in charge of signing the slip of transfer.

- Regarding public medical facilities: the person in charge of professional skills of the medical facility or the person authorized by him/her is in charge of signing the slip of transfer.

- In a shift, the leader of the team is in charge of signing the slip of transfer.

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