Things to know about medical insurance

HnTim-Things to know about health insurance

Legal basis : Law on medical insurance
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1 . What is medical insurance  ?
Health insurance is a form of insurance to be applied in the field of health care , not-for -profit organization by the State and the object implementation is responsible for participation in accordance with law .
2 . Medical insurance  is made on any principle ?
MI was performed on 5 principles :
- Ensure that risk sharing between the insured .
-Medical insurance  premiums are determined according to the percentage of salary , wages , pensions , benefits or minimum wage of administrative regions (hereinafter referred to as the minimum wage ) .
- Level of medical insurance  on the severity of disease, target groups within the rights of the insured .
- Cost of medical examination and treatment by the health insurance fund medical insurance  and the insured pays the same .
- The medical insurance  fund is managed centralized , unified , open and transparent and ensure the balance of revenue and expenditure and are protected by the State .
3 . State's policy on medical insurance  is done how ?
- State contributions or support of health insurance premiums for people with meritorious services to the revolution and a number of social groups .
- State incentives for investment activity to preserve medical insurance and fund growth . Fund's revenues and profits from investment activities were exempt from themedical insurance  fund .
- The State shall create conditions for organizations and individuals involved in medical insurance  or group health insurance premiums for the object.
- The State encourages investment and technological development of advanced vehicle engineering in insurance management .
4 . Management of state regulation of health insurance is like?
- The government unified state management of health insurance.
- The Ministry of Health is responsible to the Government for implementing state management on health insurance .
- Ministries, ministerial-level agencies shall , authority to coordinate with the Ministry of Health to manage the state of health insurance.
- People's Committees at all levels within the duties and exercise their powers to manage the state of the local health insurance .
5 . Responsibilities of the Ministry of Health on health insurance is regulated like?
The Ministry of Health is responsible for all coordination with ministries, ministerial-level agencies , agencies and related organizations perform the following tasks :
- Develop policies and legislation on health insurance , health system organization , online medical technical expertise , financial resources for the protection , care and improve people's health based on universal health insurance ;
- Develop strategies , planning and overall development plan of health insurance ;
- Issue a list of drugs , medical supplies , technical services under the effect of the insured and the technical regulations concerning medical treatment of health insurance ;
- Develop and submit to the Government measures aimed at ensuring the health insurance fund balance ;
- Propagation and dissemination of policies and legislation on health insurance ;
- Directing and guiding the implementation of health insurance ;
- Inspection , testing , handling of violations and settlement of complaints and denunciations about health insurance ;
- Monitor , evaluate and summarize activities in the field of health insurance ;
- Organization of scientific research and international cooperation on health insurance .
6 . Responsibilities of the Ministry of Finance is regulated health insurance like?
- To coordinate with the Ministry of Health , agencies , organizations related policy and legislation related to health insurance financing .
- Inspection and test the implementation of the provisions of the law on financial regulations for health insurance, the health insurance fund .
7 . Responsibilities of People's Committees at all levels of health insurance is regulated like?
Within the scope of the task , their powers , the People's Committee issued the following responsibilities :
- Directing organizations implement policies and laws on health insurance ;
- Ensure cost of health insurance premiums for the object or close state budget support under the provisions of this Act ;
- Propagation and dissemination of policies and legislation on health insurance ;
- Inspection , testing , handling of violations and settlement of complaints and denunciations about health insurance.
In addition to the implementation of the above responsibilities , PPC , central cities are also responsible for the management and use of funds in accordance with law .
8 . The act prohibited the implementation of health insurance ?
- Do not open or close fully insured in accordance with law .
- Fraud , fake profiles , health insurance card .
- Use of health insurance premiums , health insurance funds for improper purposes .
- Obstructing , making it difficult or damaging the rights and legitimate interests of the insured and of the parties relating to health insurance.
- Willful false statements , providing false information and data on health insurance.
- Abusing positions and powers , and professional services to contravene the provisions of the law on health insurance.
9 . Rights and responsibilities of the insured is specified how ?
* The right of the insured :
- Is health insurance when health insurance premiums .
- Select health insurance health care facility initially prescribed .
- Be patient examination and treatment .
- Held payment of health care costs health insurance under the health insurance regime .
- Requires health insurance organizations , health insurance and health care establishments concerned agencies to explain , provide information about health insurance .
- Complaints and denunciations violations of the law on health insurance.
* Responsibilities of the insured :
- Close insured full and on time .
- Use the right health insurance purposes , not for others to borrow health insurance .
- Implement procedures to KCB KCB MI .
- Abide by the rules and guidelines of health insurance organizations , health care at the health care facility .
- Payment of health care costs for health care facility in addition to the costs paid by the health insurance fund .
   
10 . Rights and responsibilities of organizations and individuals is regulated health insurance premiums like?
* Rights of organizations and individuals health insurance premiums :
- Requires health insurance organizations , State agencies competent to explain , provide information about health insurance .
- Complaints and denunciations violations of the law on health insurance.
* Responsibilities of organizations and individuals health insurance premiums :
- Profiling health insurance proposal .
- Close insured full and on time .
- Communicate health insurance for the insured .
- Provide complete and accurate information and documents related to the implementation of health insurance liability of the employer , the representative of the insured at the request of health insurance organizations , employees or representatives of the employees .
- To observe the inspection and examination of the implementation of the provisions of the law on health insurance.
11 . Rights and responsibilities of health insurance is regulated organization like?
* The right to health insurance organizations :
- Require employers , representatives of the insured and the insured to provide full and accurate information and documents related to their responsibility for implementing health insurance.
- Supervision of the implementation of health insurance health care , recovery , custody health insurance for violations as prescribed .
- Requires health care facility providing health insurance records , medical records , clinical documentation in order to serve the health insurance assessor .
- Refuse to pay health care costs health insurance is not prescribed by law or the contents curative health insurance contract .
- Ask the person responsible for damages to the insured reimbursement of health care costs that the organization paid health insurance .
- To propose competent state agencies to amend and supplement policies and legislation on health insurance and handling organizations and individuals who violate the law on health insurance.
* Responsibility of health insurance organizations :
- Propagation and dissemination of policies and legislation on health insurance.
- Guidance documents and procedures , implementing health insurance to ensure quick , simple and convenient for the insured .
- Thu health insurance premiums and health insurance .
- Management and use of the health insurance fund .
- Signed contracts with health insurance health care health care facility .
- Payment of health care costs health insurance.
- Provides information about health insurance and health care facilities guidance insured health care facility selected initially .
- Check the quality of health care , health insurance assessor .
- Protection of the insured ; solving competence petitions , complaints and denunciations about health insurance .
- Recordkeeping and data on health insurance as prescribed by law IT applications in health insurance management , building national database of health insurance.
- To implement statistics , reports , professional guidance on health insurance ; report periodically or upon request of the management , use insurance fund .
- Organize training , professional training , scientific research and international cooperation on health insurance .
12 . Rights and responsibilities of the health care facility is regulated health insurance like?
* Rights of insured health care facility :
- Requires health insurance organizations provide full and accurate information concerning the insured , funds health care for the insured health care facility .
- Held advance funding of health insurance and health care costs paid under the contract signed health care .
- To propose competent state agencies to handle the organizations and individuals who violate the law on health insurance.
* Responsibility of health insurance health care facility :
- Organization of health care quality assurance procedures simple and convenient for the insured .
- Providing medical records and documents relating to health care and health care costs paid by the insured as required by health insurance organizations and state agencies having jurisdiction.
- Ensuring the necessary conditions for the implementation of health insurance organizations appraisal work and coordinate with health insurance organizations in the propagation and an explanation of health insurance for the insured .
- Check , detects and notifies the insured organization breaches of health insurance used to coordinate the revoked organizations health insurance , health insurance custody for violations as prescribed .
- Manage and use health insurance funds in accordance with law .
- To carry out statistical work , according to a report on health insurance regulations .
13 . Rights and responsibilities of the representative organizations of workers and organizations representing the employers are specified like?
* The right of representative organizations of workers and organizations representing the employers :
- Requires health insurance organizations , health care establishments and employers who provide full and accurate information concerning your health insurance to employees .
- To propose competent state agencies to handle violations of the law on health insurance affect the rights and legitimate interests of the employees , the employers .
* Responsibilities of organizations representing employers and organizations representative of employers :
- Propagation and dissemination of policies and legislation on health insurance for the employee , the employer .
- Participate in the construction, modification recommendations , additional policies and legislation on health insurance.
- To supervise the implementation of the law on health insurance.
14 . The inspection , complaint and denunciation settlement of disputes and handle violations of regulations on health insurance is like?
* Health Inspectorate inspectors perform specialized functions of health insurance.
* The complaints and resolving complaints against administrative decisions , administrative actions on health insurance , and resolved to denounce alleged breaches of the law on health insurance shall comply with the provisions of law on complaints accusations .
* Disputes over health insurance :
- Disputes over health insurance disputes involving the rights, obligations and responsibilities between objects insured :
+ Persons insured under the provisions of law , the representative of the insured .
+ Organizations individual health insurance premiums under the provisions of law .
+ Health Insurance Organization .
+ Health insurance health care facility .
- Health Insurance Disputes are resolved as follows :
+ The disputing parties are responsible for the conciliation of the dispute .
+ Where conciliation fails, the parties to the dispute have the right to sue in court according to law .
* Handling of violations of health insurance :
- Any person who acts in violation of the provisions of the Health Insurance Law and other provisions of law relating to health insurance , depending on the nature and seriousness of their violations, be disciplined , administratively sanctioned or examined for penal liability , if causing damage, they must pay compensation according to law .
- Agencies, organizations, employers are responsible for paying the health insurance without fully closing or not prescribed by law, have to play along with the unpaid amount , interest amount payable in slow time played under the base rate by the State Bank announced , if not done at the request of the competent handling of administrative violations , banks , other credit institutions , the State Treasury shall deduct from the deposit account of the person responsible for payment of health insurance premiums unpaid amount , slow play and the amount of interest in the health insurance fund . / .

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