Medical Payment Processes: Exam to Treatment
- HANOI – amended health insurance regulations, effective in 2024, stipulate specific timelines for payments between medical facilities and social insurance organizations.
- Under the revised law, medical examination and treatment facilities must submit a summary of health insurance payment requests for the preceding month to the social insurance institution within...
- The social insurance organization is required to notify the medical facility of the evaluation results and the settled amount for health insurance-covered medical examination and treatment costs within...
Health Insurance Payment procedures Outlined in Amended Law
Table of Contents
- Health Insurance Payment procedures Outlined in Amended Law
- Health Insurance Payment procedures: Your Questions Answered
- What is the core focus of the amended health insurance regulations?
- What are the monthly reporting requirements for medical facilities?
- What is the quarterly reporting requirement for medical facilities?
- What are the responsibilities of the social insurance organization?
- What data is included in the notification from the social insurance organization?
- What is the timeline for notification from the social insurance organization for the fourth quarter?
- What is the payment deadline after the notification of the settled amount?
- When is the annual assessment of health insurance fund regulations completed?
- What key timelines are involved in the health insurance payment process?
- Who shoudl I contact for clarifications or further inquiries?
HANOI – amended health insurance regulations, effective in 2024, stipulate specific timelines for payments between medical facilities and social insurance organizations.
Monthly and quarterly Reporting Requirements
Under the revised law, medical examination and treatment facilities must submit a summary of health insurance payment requests for the preceding month to the social insurance institution within the first 15 days of each month. Additionally, a report detailing the costs associated wiht health insurance medical processing for the previous quarter is due within the first 15 days of each quarter.
The social insurance organization is required to notify the medical facility of the evaluation results and the settled amount for health insurance-covered medical examination and treatment costs within 30 days of receiving the quarterly payment report. This notification includes the actual medical examination and treatment costs within the scope of health benefits and insurance services. For the fourth quarter, the notification deadline is extended to 60 days from the date the social insurance organization receives the payment report.
Payment Deadline
Following notification of the settled amount for health examination and processing costs, the social insurance organization has 10 days to make the payment to the medical facility.
Annual Assessment
the annual assessment of health insurance fund regulations must be completed before October 1 of the following year.
Clarification Contact
For inquiries or clarifications, individuals are directed to contact the Department of Political Affairs and Party, Journal of the People’s Army, at n ° 7 Phan Dinh Phung, Hoan Kiem, Hanoi; Telephone: 069.554119; 024.37478610; or via email.
Health Insurance Payment procedures: Your Questions Answered
This article provides a complete overview of the health insurance payment procedures outlined in the amended law, effective in 2024. We’ll address common questions adn provide clear, concise answers to help you understand the key aspects of these regulations.
What is the core focus of the amended health insurance regulations?
The amended health insurance regulations, effective in 2024, primarily focus on establishing clear timelines for payments between medical facilities and social insurance organizations. The regulations streamline the payment process for health insurance claims.
What are the monthly reporting requirements for medical facilities?
Medical examination and treatment facilities are required to submit a summary of health insurance payment requests for the preceding month to the social insurance institution. This summary must be submitted within the first 15 days of each month.
What is the quarterly reporting requirement for medical facilities?
In addition to the monthly summary, medical facilities must also submit a report detailing the costs associated with health insurance medical processing for the previous quarter. This quarterly report is due within the first 15 days of each quarter.
The social insurance organization has the following responsibilities:
Evaluation and Notification: To notify the medical facility of the evaluation results and settled amount for health insurance-covered medical examination and treatment costs. This must be done within 30 days of receiving the quarterly payment report.
payment: To make the payment to the medical facility within 10 days of notifying the settled amount.
The notification from the social insurance organization includes the actual medical examination and treatment costs covered by health benefits and insurance services.
The notification deadline for the fourth quarter is extended to 60 days from the date the social insurance organization receives the payment report.
What is the payment deadline after the notification of the settled amount?
The social insurance organization has 10 days to make the payment to the medical facility following notification of the settled amount.
When is the annual assessment of health insurance fund regulations completed?
the annual assessment of health insurance fund regulations must be completed before october 1 of the following year.
What key timelines are involved in the health insurance payment process?
Here’s a table summarizing the key deadlines:
| Action | Deadline |
|---|---|
| Monthly Report Submission (Medical Facility) | First 15 days of each month |
| Quarterly Report Submission (Medical Facility) | First 15 days of each quarter |
| Notification of Evaluation Results and Settled Amount (Social Insurance Organization) | Within 30 days of receiving the quarterly report (excluding Q4) |
| Notification of Evaluation Results and Settled Amount (Social Insurance Organization – Q4) | Within 60 days of receiving the Q4 report |
| Payment to Medical Facility (Social Insurance Organization) | Within 10 days of notification of the settled amount |
| Annual Assessment Completion | Before October 1 of the following year |
Who shoudl I contact for clarifications or further inquiries?
For inquiries or clarifications, you can contact the Department of Political Affairs and Party, Journal of the People’s Army, at n ° 7 Phan Dinh Phung, Hoan Kiem, Hanoi. you can also reach them by telephone: 069.554119 or 024.37478610,or via email.