'Shocked' with health insurance referral papers

"Expiration date" is 12 months but health insurance referral paper still expires

That is the situation of Mrs. Tran Thi D. (address in Bac Tu Liem District, Hanoi). According to the patient's family, Mrs. D. has COPD. Recently, when she had a health check at Bach Mai Hospital, the doctors assessed her condition and determined that she needed to be transferred to a higher-level hospital, to prescribe appropriate medication and be monitored by specialists.

Health insurance patients were denied due to not knowing the regulation "transfer voucher is valid for 10 working days from the date of signing"

PHOTO: PROVIDED BY PATIENT'S FAMILY

Ms. D. was taken by her family to the initial health insurance registration clinic at the Bac Tu Liem District Medical Center, and was given a health insurance referral to a leading general hospital in Hanoi.

When the referral letter was received, because the patient's family still had a prescription and contacted the hospital where she was transferred, they received the reply "that referral letter is valid for 12 months", so the family did not take her to see a doctor immediately.

This February, her family took Ms. D. to the hospital where she was referred by the local health department. However, at the hospital, the receptionist said that the health insurance referral paper had expired and she could not be examined.

Even though it was a cold and rainy day, she was very tired due to COPD and had to fast since morning, but Ms. D. still had to go home.

No instructions, no notes on referral form

Regarding Mrs. D's case, her daughter, Ms. Tuyet, said: "According to the explanation of the hospital reception staff, my mother was not examined, even though the referral paper was valid for 12 months, because "within 10 days of being transferred for health insurance examination, the patient must go for examination at the place they were transferred to. If after this time, the referral paper expires, and the registration for examination will not be accepted."

According to Ms. Tuyet: "The hospital did not accept her for examination, because it had been more than 10 days, so I took my mother back to the original clinic to ask for a referral, even though she was weak and tired due to COPD."

"For a long time, my mother has been using health insurance at the right place, and recently the family learned that the health insurance transfer paper is valid for 12 months, so we have not taken her to see a doctor right away, waiting for the medicine in the old prescription to run out," Ms. D's family explained the reason for not taking her to see a doctor right away after receiving the transfer paper.

According to Ms. D's daughter: "The most important thing for patients is to know all the regulations, including the requirement: "patients must see a doctor within 10 days after receiving the referral letter", but we were not given any instructions. Even the referral letter did not include this regulation, causing my mother to have a very difficult time traveling, while her health was poor", the patient's daughter was upset.

Regarding the "12-month validity" of the referral certificate for medical examination and treatment under health insurance, a representative of the Department of Health Insurance (Ministry of Health) said that after receiving a referral certificate for chronic diseases, patients can continue to be examined at the place they were referred to for 12 months, instead of having to re-apply for a referral certificate after each examination, as prescribed before 2025.

"Currently, the referral form does not include the content "the patient must be examined within 10 working days from the date of signing the referral for treatment", a representative of the Health Insurance Department confirmed.

"The health sector has some more favorable regulations for people with health insurance. The health sector and social insurance need to have more specific instructions on procedures. Or, the simplest way is to clearly state the regulation "patients must be examined within 10 days from the date of signing the referral for treatment" on the referral form so that patients know and follow it. With just that line, medical staff do not necessarily have to spend a lot of time explaining, and patients do not encounter "failed examination" situations like my mother did," Ms. Tuyet suggested.

Source: https://thanhnien.vn/nga-ngua-voi-giay-chuyen-tuyen-bao-hiem-y-te-185250303142703322.htm