Kathmandu. KATHMANDU: The Health Insurance Board (HIB) has issued a 9-point directive to the health institutions providing the service after they complained of inconvenience while visiting the referral centers.
The directive has been issued as per the executive director level decision of the board on October 27. The Board has complained in writing and orally that the insured person has to face various procedural difficulties due to the lack of service at the first service point and being sent to the dispatch center. In order to address these complaints, the Board has issued directives to all the service providing organizations associated with the health insurance program.
Here are the instructions
In case of serious diseases (cancer, heart disease, kidney disease, head injury, spinal injury, sickle cell anemia, Parkinsonism, Alzheimer’s), referral is not required once from the first service point and follow up at the same hospital for the same problem.
As per the prevailing law, a family with a very poor identity card, extremely disabled, leprosy patients, HIV infected, serious tuberculosis patients, senior citizens above 70 years of age, women health volunteers are referred to the same hospital once referred and referred again to the same hospital for follow-up.
In case of serious eye health problems, pregnant and lactating diseases, other complex diseases such as asthma, severe mental illness, referral from the first service point and follow up at the same hospital for the same problem is not required.
A remittance service for one disease does not require a new remittance when re-checked for the same disease.
After taking emergency care, if there is a follow-up for the same disease, there is no need for a one-time referral.
If the diagnosis of another disease is immediately required if it is being referred for treatment from the first service point, the service should be provided by dispatching it to another department of the same hospital.
If there is a need to follow up with the same department by taking services from other departments, then re-referral is necessary.
In case of shortage of service from the dispatch center, the service should be ensured and sent to the nearest hospital.
Arrangements should be made to ensure easy access to services to physically weak, senior citizens and people with different abilities.
