Traveled thousands of kilometers but was not accepted
According to the reflection of Ms. Kim Ngan (living in Hanoi), her family member works in a remote province, about 1,400 km from Hanoi. Recently, due to illness, her family member went to a special-class hospital in Hanoi for examination and treatment. After treatment, the patient was scheduled for a follow-up examination after 1 month and was instructed to apply for a health insurance transfer certificate to enjoy benefits paid by health insurance.
The Ministry of Health requires medical facilities to provide full instructions to patients on health insurance transfer procedures.
PHOTO: NGOC THANG
The patient returned to his workplace and initially registered for health insurance (in the south) and requested a health insurance transfer certificate to a central hospital in Hanoi . As scheduled, the patient went to Hanoi, returned to the hospital for a follow-up examination after 1 month and brought the health insurance transfer certificate. "At the place where the procedure was done, the receptionist said that the patient's health insurance transfer certificate was not accepted because the patient's examination was 10 days later than the time the health insurance transfer certificate was signed. If the patient wants to receive health insurance payment, the patient needs to re-apply for the health insurance transfer certificate," said Ms. Kim Ngan.
"Neither the patient nor their family members were instructed about the regulation that they must return for a re-examination within no more than 10 working days after requesting the health insurance transfer certificate. If it is more than 10 days, the health insurance transfer certificate will expire," Ms. Ngan affirmed.
According to Ms. Ngan, because she initially registered for medical examination and treatment in a southern province, too far from Hanoi, the patient could not return to the provincial health department to request another health insurance transfer certificate, to replace the one she requested the first time.
"The staff and doctors at the place where the health insurance was transferred and the place where the health insurance transfer form was received did not provide any instructions; the health insurance transfer form also did not state the requirement for the patient to be examined within 10 days. Therefore, we did not know how to do it. The patient did not receive any benefits, even though it took time and effort to travel," the patient's family complained.
Not only the above case, Thanh Nien reporters also received some feedback from patients and their families about having to re-apply for health insurance transfer papers because they were not instructed by medical facilities about the "10-day deadline" mentioned above.
According to the representative of the Health Insurance Department (Ministry of Health), health insurance participants with chronic diseases and groups of diseases (specified in Appendix 3 of Circular 01/2025) are allowed to use a referral voucher for medical examination and treatment facilities that is valid for 1 year from the date of signing. In case the referral voucher expires while the patient is still undergoing medical examination and treatment and needs to continue treatment at the medical examination and treatment facility, the referral voucher is valid until the end of that treatment period.
A representative of the Health Insurance Department said that the current Health Insurance transfer form has a list of diseases that can be used within 1 year. Hospitals should take note to apply it, not making patients have to go back to get the transfer form. "We are urging medical facilities to implement it correctly. The 10-day regulation applies to acute diseases that need to be transferred to serious diseases to ensure that patients receive timely treatment. As for chronic diseases, we can delay it," a representative of the Health Insurance Department affirmed.
Need to ensure the rights of health insurance participants
To unify implementation, ensure the rights of health insurance participants, and avoid arising problems, the Ministry of Health recommends that directors of provincial health departments and directors of medical examination and treatment facilities, based on the provisions of Circular 01/2025/TT-BYT, pay attention to instructions on transferring patients between general and specialized facilities, between technical expertise levels, ensuring compliance with the technical expertise hierarchy of local medical examination and treatment facilities, capacity and strengths of the facility, avoiding overload and frequent patient transfers.
Regarding the responsibilities of medical facilities, the Ministry of Health requires urgent training for medical staff on new regulations of the law on health insurance, especially regulations on procedures and processes for medical examination and treatment, contents on re-examination appointment forms, patient transfer forms; carefully study to properly implement the provisions of Circular 01/2025/TT-BYT and appendices 1, 2, 3 and 4 issued therewith to ensure the rights of patients.
In particular, medical facilities are responsible for not providing instructions or providing incomplete instructions, causing inconvenience and affecting the rights of health insurance patients.
Source: https://thanhnien.vn/chuyen-bao-hiem-y-te-benh-vien-can-nam-ro-tranh-phien-ha-cho-nguoi-benh-185250706215425452.htm
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