Health insurance medical examination and treatment process: Fast and convenient at Hospital 199

Health insurance medical examination and treatment procedures are the steps that health insurance participants must take when going to a medical examination and treatment facility to enjoy health insurance benefits. Health insurance medical examination and treatment procedures depend on the patient’s specific case, but in general include steps performed in the following order:

1) For people going for medical examination and treatment: Present a valid health insurance card and photo identification. In addition, depending on each case, you may have to present some other documents.

2) Medical examination and treatment facility (or permanent assessor at the medical examination and treatment facility): check the validity of the above documents when presented by the patient, and resolve the health insurance regime for the patient.

After completing the health insurance medical examination and treatment procedures, the patient will be directly paid by health insurance for medical examination and treatment costs according to the benefit rate at the medical examination and treatment facility.

Pursuant to Decision No. 4384/QD-BYT dated December 1, 2023 issued by the Ministry of Health on the publication of 2 amended and supplemented administrative procedures in the field of health. Accordingly, the steps in the health insurance examination and treatment process at medical facilities are as follows:

Step 1: Medical examination and treatment records to enjoy health insurance according to regulations.

Patients come to the medical check-in counter with health insurance and present the following documents to the medical staff:

1) Paper health insurance card, or electronic health insurance card (image of health insurance card on VssID, VNeID application or integrated identification card) is still valid.

2) Identification documents such as citizen identification cards with electronic chips; Level 2 electronic identification QR code, CCCD card image on the VNeID application or ID card.

3) Declaration of participation and adjustment of social insurance and health insurance information according to Form TK1-TS.

   – For children under 6 years old, only the health insurance card and a copy of the birth certificate or birth certificate must be presented.

   – In case the health insurance participant is admitted to the emergency room, receives medical treatment at any medical facility and must present the health insurance card along with identification documents before leaving the hospital.

In some cases such as follow-up examinations or treatment referrals, health insurance participants prepare a number of other related documents such as:

   – Appointment letter for re-examination from medical facility in case of re-examination as required for treatment.

   – Medical insurance referral certificate and referral records of the health insurance medical facility in case of referral for treatment.

See more: Hospital 199 – BCA | Answering questions about out-of-network health insurance at hospital 199

  Health insurance health care facilities are responsible for promptly transferring patients to other health care facilities in case they exceed their technical and professional capabilities according to regulations.

Thus, medical examination and treatment records, including health insurance cards, identification documents and other documents depending on the case (such as referral papers, re-examination appointment papers, work papers, temporary residence registration papers) …).

Medical staff will photocopy the necessary documents into a set of documents and send them back to the patient with information about where to receive medical records.

Step 2: Submit the medical examination and treatment dossier to the medical examination and treatment facility, so that the facility can check the validity of the dossier and is responsible for resolving it immediately after presenting the health insurance card and the health insurance benefits dossier to the patient. sick.

Step 3: Pay medical examination and treatment costs directly at the medical examination and treatment facility, according to the patient’s health insurance contribution rate. Medical examination and treatment costs covered by health insurance are deducted directly from medical examination and treatment costs when completing payment procedures at the end of treatment.

You need to go to the payment counter in the medical examination and treatment area with health insurance to pay the patient’s medical examination and treatment costs. You only have to pay the remaining amount after deducting the amount paid by health insurance.

During the process of medical examination and treatment at a medical facility, patients may have to buy medication and treatment support as prescribed. In case you seek medical treatment and have health insurance, you will also be supported with some medications. Please bring your prescription to the health insurance pharmacy to receive free medicine or receive price support from health insurance to help you optimize costs.