Payment and settlement between medical examination and treatment facilities and...

Answer: According to the Law amending and supplementing a number of articles of the Law on Health Insurance (HI) in 2024, payment and settlement between medical examination and treatment facilities and social insurance agencies are carried out as follows:

Within the first 15 days of each month, the health insurance examination and treatment facility is responsible for sending a summary of the request for payment of the health insurance examination and treatment costs of the previous month to the social insurance agency; within the first 15 days of each quarter, the health insurance examination and treatment facility is responsible for sending a report on the settlement of the health insurance examination and treatment costs of the previous quarter to the social insurance agency;

Within 30 days from the date of receipt of the previous quarter's settlement report of the medical examination and treatment facility, the Social Insurance agency shall be responsible for notifying the medical examination and treatment facility of the appraisal results and the settlement number of medical examination and treatment costs covered by health insurance, including the actual medical examination and treatment costs within the scope of benefits and the level of health insurance benefits. For the fourth quarter of the year, the deadline for notifying the appraisal results and the settlement number of medical examination and treatment costs covered by health insurance shall not exceed 60 days from the date the Social Insurance agency receives the fourth quarter's settlement report of the medical examination and treatment facility;

Within 10 days from the date of notification of the settlement number of health insurance examination and treatment costs, the Social Insurance agency must complete the payment to the medical examination and treatment facility;

The annual settlement appraisal of the health insurance fund must be done before October 1 of the following year.

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Source: https://baodaknong.vn/thanh-toan-quyet-toan-giua-co-so-kham-benh-chua-benh-va-co-quan-bao-hiem-xa-hoi-250271.html