• QUESTION AND ANSWER
Sender:
Employee
Email:
Send Date:
04/03/2024
Fields:
FAQ
Status
Replied
Content:

How is the time limit and result regulated for the administrative procedure 'Issuing Certificates of non-co-payment within the year without direct payment of HI-based healthcare costs'?

Answer by:
VSS
Answer Date:
22/03/2024
File attachment:
Answer:

Based on point 3.3, clause 3, Section IV of the Appendix accompanying Decision No. 896/QD-BHXH of the Director-General of Vietnam Social Security:

• The time limit for resolving 'Issuing Certificates of non-co-payment within the year without direct payment of HI-based healthcare costs' is:

a. 01 working day for cases where health insurance participants meet the following conditions:

+ Submit sufficient invoices, original payment receipts, and co-payment documents (or photocopies certified by the Receiving and Result Confirming Section) or photocopies with confirmation from the medical facility where the participant received treatment, showing the co-payment amount for HI-based healthcare costs (5% or 20%);

+ Have a continuous 05-year health insurance participation history in a province or the health insurance card indicates continuous participation for 05 years.

b. 03 working days for cases where participants submit complete documents as described above but have participated in health insurance in another province or the health insurance card does not indicate continuous participation for 05 years.

c. 05 working days for cases where only in-province treatment is involved. In this case, the participant submits a photocopy of the invoice, receipt, and cost list for healthcare expenses, according to Form No. 01/BV, 02/BV.

d. 10 working days for cases where healthcare treatment is received outside the province. In this case, the participant submits a photocopy of the invoice, receipt, and cost list for healthcare expenses, according to Form No. 01/BV, 02/BV.

• The result of resolving the administrative procedure 'Issuing Certificates of non-co-payment within the year with direct payment of BHYT healthcare costs' is demonstrated through:

Certificate of non-co-payment within the year; If the certificate is not issued, the result is a written response from the Social security agency specifying the reason.

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