Now, a standard discharge summary is mandatory (with format) when a service provider enters a claim.

Kathmandu. Service providers affiliated with the health insurance program will now have to submit a standard discharge summary mandatorily when submitting a claim.

The Health Insurance Board has issued a circular to all service providers, directing them to submit a standard discharge summary mandatorily when submitting a claim.

The Insurance Board had made it mandatory to submit a standard discharge summary prepared in accordance with (c) of Sub-section (3) of the Insurance Claim Review and Evaluation Procedure, 2078 (First Amendment 2081). The amendment was approved by the Insurance Board’s meeting on Magh 2.

Now, from Falgun 1, service providers will have to implement the standard discharge summary format while submitting claims.

The amendment subsection stipulates that when a service provider submits a claim, it is mandatory to include the final diagnosis in IMIS, the doctor’s NMC number, and the standard discharge summary prepared by the Health Insurance Board.