Guidance on payment for COVID-19 testing costs according to health insurance regime in Vietnam

According to the Official Dispatch No. 2539/BHXH-CSYT of Vietnam Social Security, to ensure payment of healthcare costs under health insurance in accordance with regulations, Vietnam Social Security requests provincial social security agencies to:

1. Make payments for healthcare costs covered by health insurance

For people infected with COVID-19 treated at a newly established field hospital:  The provincial social security agency shall pay for health costs within the scope of payment by the health insurance fund according to the instructions in Official Dispatch No. 2146/BYT-BH and Official Dispatch No. 2276/BYT-BH with contracting health facilities in the administrative divisions assigned by competent authorities to be the focal point in managing and supplying drugs and medical supplies ... serving the examination and treatment at that field hospital.

2. For the COVID-19 testing costs

- The provincial social security agency shall coordinate with the contracting health facilities to record the COVID-19 testing costs of the cases in which the holder of the health insurance card tests for COVID-19 in the cases specified in Clause 1 of Official Dispatch No. 4051/BYT-KHTC of the Ministry of Health, in specific:

+ Patients must take medical isolation measures or forcible medical isolation at health facilities.

+ People infected with COVID-19 are receiving medical treatment at health facilities that accept health insurance.

+ Cases designated by contracting health facilities to perform tests under the guidance of the Ministry of Health on diagnosis and treatment of acute respiratory syndrome caused by nCoV together with Decision No. 3351/QD-BYT dated July 29, 2020.

- Aggregation of COVID-19 testing costs: The provincial social security agency shall coordinate with the contracting health facilities in aggregating the COVID-19 testing costs according to the price specified in Clause 2 of Official Dispatch No. 4051/BYT-KHTC, health insurance payout to entities as if they are examined and treated in health facilities with proper levels as follows:

+ At the health facility that has signed a contract to accept health insurance in examination and treatment: aggregate the cost according to the number of orders to do tests and number of tests done concerning holders of health insurance cards.

+ At the field hospital: The provincial social security agency shall coordinate with the contracting health facilities in the province which are assigned by competent authorities to be the focal point for management and supply of drugs and medical supplies ... in providing examination and treatment at the field hospital to aggregate the cost of testing COVID-19 of the holders of health insurance cards.

- Encoding COVID-19 tests: Provincial social security agencies shall add ".SC2" at the end of the character sequence code of medical procedures, in specific:

+ For COVID-19 tests done at that medical facility:  XX.YYYY.ZZZZ.K.SC2.

+ For COVID-19 tests done by another health facility through transfer of specimens: XX.YYYY.ZZZZ.K.WWWWW.SC2.In which the characters XX.YYYY.ZZZZ.K.WWWWW shall be written in accordance with the instructions in Clause 4 Article 3 of Circular No. 09/2019/TT-BYT.

Note: The COVID-19 testing costs which have been paid by other sources of funds shall not be aggregated; and health facilities must purchase chemicals and medical supplies to do COVID-19 tests in accordance with regulations or under the guidance of competent authorities in the COVID pandemic prevention and control.

View more details at the Official Dispatch No. 2539/BHXH-CSYT of Vietnam Social Security, issued on August 10, 2020.

Le Hai

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