Kathmandu. Under the proposed draft circular of Vietnam’s Ministry of Health, health care providers may face administrative penalties if they submit health insurance data late.
The rule, which seeks public comment until October 7, aims to regulate digital transformation, electronic transactions, and data sharing in the health insurance sector. If approved, the circular will go into effect on January 1, 2027. Circular No. 48/2017/TT-BYT will be replaced.
Under the proposed rules, health care providers will have to submit electronically signed data related to insurance-covered medical check-ups and treatment expenses on the health insurance assessment portal within three hours of the patient’s discharge. Unless they have a special exemption.
The patient will have 15 days from departure to collate, verify and submit final, unaltered data for payment evaluation requests.
The Health Insurance Evaluation Portal will release the assessment results within 15 days of receipt of the payment request. It will mention the amount approved and the legal reasons for the rejected claims. To ensure compliance, the portal will issue automated monthly reminders and warnings for unexplained delays.
Failure to comply with the rules after receiving two written notices from the Office of Social Security may result in administrative fines or referrals to competent authorities under the Health Care Administration Act. – Agency
