One of the issues that reporters of the Journalist & Public Opinion Newspaper are concerned about is the situation where patients with chronic diseases such as cancer go to a tertiary hospital for examination, then have to have a follow-up examination many times a year, but each time they have a follow-up examination, they are required to have a referral/hospital transfer paper to be paid for health insurance.
Faced with somewhat cumbersome procedures, many patients do not have enough patience to ask for a referral letter, so they pay for medical services that are not covered by health insurance despite their limited financial capacity. Some people even do not comply with follow-up examinations.
Many patients with cancer and chronic diseases, after completing treatment, have a follow-up appointment with their doctor, but to receive social insurance, they need a referral letter from a lower-level hospital (illustrative photo).
Regarding this issue, MSc. Tran Thi Trang, Director of the Department of Health Insurance (HI), Ministry of Health, shared. Ms. Trang said, "It is true that this situation occurs, but not all facilities have this situation."
Ms. Tran Thi Trang said that regarding this issue, the Ministry of Health has had many solutions to resolve difficulties related to re-examination appointment papers and re-examination scheduling.
Firstly, according to Directive No. 25/2020 of the Minister of Health, facilities must classify patients for follow-up appointments, implement an appointment system on the phone, online... so that there are not too many patients at the same time, causing long waiting times.
The Ministry of Health regularly sends official dispatches urging medical facilities to implement this.
Second, the Ministry of Health is researching a simpler way to make follow-up appointments.
Accordingly, instead of requiring the medical facility leader to sign this paper as is currently the case, it is possible to delegate this task to the heads of departments and rooms in the medical facility so that many people can sign this paper, helping patients not have to wait.
Third, Decree 75 amending and supplementing a number of articles of Decree 146 detailing and guiding the implementation of a number of articles of the Law on Health Insurance issued by the Government, which has just taken effect since December 3, also has regulations related to this appointment paper, including solutions to reduce administrative procedures and inconvenience for patients.
Specifically, according to the old regulations, patients are scheduled for a follow-up appointment at a certain time or at any time before the appointment date if there are unusual signs (symptoms). The appointment paper is only valid for one use within 10 working days from the date of the appointment date.
If you do not return for a check-up within 10 days, the appointment will expire. If you want to enjoy health insurance in the right area, you must apply for a referral in accordance with regulations.
According to the new regulation, according to Ms. Trang: "If the patient cannot return within 10 days of the re-examination appointment, they can contact the medical facility in advance to request another appointment.
That way, patients don't have to re-apply for an appointment and don't have to wait," said Ms. Trang.
In the near future, the Ministry of Health will apply information technology and digitize documents such as referral papers, hospital discharge papers and re-examination papers in electronic form.
"We are asking for opinions from medical facilities and social insurance agencies about the fields of information to digitize these types of documents. After being issued, we will test it for 6 months. If it is suitable, it will help reduce inconvenience for patients," said Ms. Trang.
Accordingly, electronic referral papers can be integrated into the health insurance card application, the patient's health insurance card code or citizen identification code or through the VssID system of Vietnam Social Security.
When coming to the facility to request a re-examination appointment, the patient can bring the electronic health insurance card or citizen identification code to the receiving facility to receive medical examination and treatment and enjoy health insurance according to regulations.
Or through the VssID system, medical facilities can look up information themselves. After the trial period, the Ministry of Health will make adjustments and officially issue it.
Fourth, in addition to decentralizing the signing of documents, a solution to simplify procedures is being studied, which is to implement electronic signatures, electronic seals, and electronic signatures instead of regular signatures (wet signatures) to be faster. Accordingly, leaders of departments and offices can sign documents wherever they are.
Ms. Trang also emphasized that for documents such as referral papers and re-examination appointment papers issued in 2023, the Department of Health Insurance will issue an official dispatch urging and guiding facilities to be able to issue papers to patients in December, instead of having to wait until January 2024 to issue and implement in 2024.
Thus, it can be seen that increasingly, reforms related to medical examination and treatment procedures will aim to create maximum conditions for people, especially chronic patients, to access healthcare in the most convenient way. Hopefully, the above reforms will help patients no longer have to fear asking for a hospital transfer certificate to enjoy health insurance.
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