Step 1: A requester for payment of health insurance-covered medical care costs (the patient or his/her relative) shall submit medical care dossier and documents to the social insurance agency Step 2: The social insurance agency a/ A single-window division shall receive the dossier and documents, make the copies of the papers (including health insurance card, hospital discharge paper, medical book, prescriptions, etc.,), sign for certification on such copies and return the originals to the requester; input data into the dossier receiving software, and print a slip of dossier receipt and appointing a result notification date (made according to Form No. 01 promulgated together with Decision No. 999/QD-BHXH) to the requester; and then, transfer the dossier of request for direct payment of health insurance-covered medical care costs to the health-insurance assessment division (or the assessment section of the district-level social insurance agency). b/ The health-insurance assessment division (or the assessment section of the district-level social insurance agency): -Within 2 working days, to issue a written assessment request for those who take medical care outside the district (in case the district-level social insurance agency receives the dossier) or outside the province (in case the provincial-level social insurance agency receives the dossier); - Within 25 days, the social insurance agency which receives the written assessment request must complete the assessment; and give a reply on the assessment result to the social insurance agency requesting the assessment, enclosed with the list of medical care costs; - Within 3 days after receiving the assessment result, the health-insurance assessment division (or the assessment section of the district-level social insurance agency) must complete the Table of direct payment of medical care costs and forward it to the Planning-Finance Division (or the planning-finance section of the district-level social insurance agency). In case of refusing the payment, the health-insurance assessment division /section shall submit to a leader of the social insurance agency for signing a written notice thereof, clearly stating the reason, and forward such notice to the single-window division for returning to the requester. c/ The Planning- Finance Division (or the planning-finance division of the district-level social insurance agency) shall, within 2 days after receiving the Table of direct payment of medical care costs, check the validity of the invoices and documents, complete the dossier of request for direct payment of health insurance-covered medical care costs, and notify the single-window division of the settlement result, and make payment to the requester.

Submitting the dossier in the single-window division

- The originals of valid papers (including purchase invoices of drugs and medical supplies; invoices or receipts of hospital fees and related papers). - The original of health insurance card which remains valid and one of valid identification papers stuck with photo (people’s identity card, passport, party membership card, people’s public security officer card, soldier card, trade union membership card, pupil card, student card, veteran card, driving license or another valid paper stuck with photo) in case the health insurance card has no photo, or a copy of birth certificate or written birth certification for under-6 children who don’t have health insurance card. - Slip of dossier receipt and appointing a result notification date issued by the social insurance agency (pending the re-grant or renewal of health insurance card); - Hospital discharge paper and medical book (the originals or copies); - Certificate of organ donation (if any); The dossier-receiving officer shall make copies of health insurance card (or birth certificate or written birth certification in case no health insurance card is available; slip of dossier receipt and appointing a result notification date in case of re-grant or renewal of health insurance card; and certificate of organ donation) and a valid identification paper stuck with photo, hospital discharge paper and medical book to be kept in the dossier, and return the originals to the patient.

Within 40 days after receiving a complete dossier

1. When submitting the dossier: No 2. When receiving the result: a/ In case the beneficiary directly receives the result: He/she shall produce the slip of dossier receipt and appointing a result notification date and his/her people’s identity card. b/ In case another person receives the result on behalf of the beneficiary: - If such person is the beneficiary’s relative, he/she shall produce the slip of dossier receipt and appointing a result notification date, his/her people’s identity card, and a paper proving the relationship between him/her and the beneficiary (a copy of household registration book, birth certificate, written birth certification or marriage certificate, etc.). - If such person is the beneficiary’s guardian, he/she shall produce the slip of dossier receipt and appointing a result notification date, his/her people’s identity card, and a paper proving he/she is the beneficiary’s natural guardian (a copy of household registration book, birth certificate, written birth certification or marriage certificate, etc.). If no natural guardian is available as prescribed by law, to produce the slip of dossier receipt and appointing a result notification date, his/her people’s identity card and the competent authority’s decision on guardianship recognition. - If such person is not the beneficiary’s relative or guardian as mentioned above, he/she shall produce the slip of dossier receipt and appointing a result notification date, his/her people’s identity card and the written authorization made according to Form No. 18a-CBH promulgated together with the Vietnam Social Security’s Decision No. 919/QD-BHXH of August 26, 2015.