Kathmandu. The Health Insurance Board has directed the health institutions not to make unnecessary referrals.
The Insurance Board issued a notice to all the service providers listed at the first service point today. “It has been found that some of the service providers, who act as the first service points signed with the Health Insurance Board, have made unnecessary remittances against the Health Insurance Act 2074, Regulations 2075, Referral Service Procedures 2080, Claim Review Guidelines, (First Amendment) 2081 and conduct of medical services despite having sufficient capacity to provide services themselves and to make necessary arrangements for the availability of services.” The notice states, “Therefore, do not allow the service being done in your organization to not be sent without providing it. ’
The Board has directed to send a clear statement as per schedule-9 of the rules by mandatorily stating the reasons if it has to be remitted. “In the Health Insurance Act, 2074 AND The Health Insurance Rules, 2075 (including amendment), the service providers listed as the first service points should provide necessary medical services to the insured,” reads the notice. ’
