Chapter III
IMPLEMENTARY RESPONSIBILITIES
Article 10. Responsibilities of the Ministry of Health
1. Lead, provide instructions on, inspect transfer of electronic data containing information about covered medical services, verification and payment of covered medical costs, with respect to Departments of Health, healthcare establishments of Ministries, sectoral departments, healthcare establishments providing covered medical services and entities charged with receiving and managing electronic data.
2. Take charge of and collaborate with the Vietnam Social Security and other entities, organizations or individual concerned in:
a) Compiling, updating, modifying, revising and supplementing the general nomenclature, formats and standards of output data and other relevant regulations for the purpose of implementation of this Circular;
b) Regulating transfer, receipt, responding to, verifying electronic data containing information about covered medical services in certain particular cases;
c) Establishing the system of information regarding management of covered medical services and issuing directive documents thereof;
d) Receiving and handling any difficulty or problem that may arise in the course of implementation.
3. Assure receipt, management and use of electronic data containing information about covered medical services and other data used for the state management purpose at the Health Insurance Data Receipt Portal of the Ministry of Health.
4. Assign Departments, Authorities, Administrations or relevant affiliates or subordinate entities of the Ministry of Health to organize activities to meet requirements concerning management and payment of covered medical costs.
Article 11. Responsibilities of the Vietnam Social Security
1. Provide sufficient personnel and infrastructure systems like servers, workstations, transmission lines, software and databases of health insurance cards and Health Insurance Information Verification Portal to meet demands for access to information about covered medical services, manage health insurance network linkage, receive, respond to, protect security for electronic data indicating the request for verification and payment of covered costs which are sent from healthcare establishments to social security agencies in a quick, sufficient and accurate manner.
2. Apply general nomenclature codes in a full and accurate manner, regulations on standards and formats of output data approved by the Minister of Health, satisfy request for receipt and management of electronic data sent from healthcare establishments for the purposes of verification and payment of covered costs.
3. Submit the general nomenclature that the Vietnam Social Security has already established or planned to establish or supplement for the Minister of Health’s official approval.
4. Establish, issue and release the database of health insurance cards, processes or rules for electronic inspection carried out through the software system that ensures connection between the system for verification and payment of health insurance-covered costs and the software system for management of covered health examinations or treatments of healthcare establishments, and bear its responsibility for the status, accuracy, confidentiality, safety and security of the database of health insurance cards and electronic data of cardholders which have been transferred to the Health Insurance Verification Information Portal administered by a social security body.
5. Direct social security agencies at all levels to implement this Circular; pay in time and in full covered costs to healthcare establishments in accordance with laws in force.
6. Collaborate with the Ministry of Health in computerizing covered health check-ups and treatments and sharing all necessary information used for the state management accorded the Ministry of Health and implementing duties assigned by the Vietnam Social Security.
Article 12. Responsibilities of Departments of Health of centrally-affiliated cities and provinces, and healthcare establishments of Ministries and sectoral departments
1. Organize activities to initiate, direct, guide, inspect and expedite use of general nomenclature codes, standards and formats of output data which have been approved by the Minister of Health, ensure the due transfer of electronic data for the purposes of management, payment of covered costs of health check-ups and medical treatments provided by healthcare establishments under their jurisdiction, and compliance with provisions laid down herein.
2. Exploit and use the database available on the Health Insurance Information Verification Portal and the Health Data Receipt Portal of the Ministry of Health for the purposes of management which is relevant to their assigned functions, duties and powers. In the course of exploitation and use of the electronic database, ensure confidentiality and security for information and data on patients’ health check-ups and treatments in accordance with laws on information technology, network security, health check-up and medical treatment as well as others.
3. Take charge of and collaborate with relevant bodies in resolving any difficulty that may arise in the course of implementation of this Circular. In the event of failure to do so, they must report to competent authorities to seek their decision.
Article 13. Responsibilities of healthcare establishments
1. Apply general nomenclature codes; standards and formats of output data; electronic certifications which have been approved by the Minister of Health, ensure the due, sufficient, accurate and authentic transfer of electronic data exactly describing the history of a patient’s health check-ups and medical treatments for the purpose of management of health check-ups and medical treatments, and verification and payment of covered medical costs.
2. Have access to information of patients’ health insurance cards in order to ensure benefits and interests between parties concerned in accordance with laws.
3. Have the burden of ensuring accuracy of healthcare data, confidentiality of healthcare information and data of patients in accordance with laws.
4. Report to regulatory bodies and social security agencies in case of any change to the persons authorized to manage, grant the electronic certification and use accounts related to transfer of electronic data used for management of health checkups and medical treatment activities and payment of covered medical costs.
5. Comply with any direction or requirements concerning examination, inspection and supervision which are laid down under laws.
6. Affix their signature to validate covered costs of health checkups and medical treatments provided by healthcare establishments in the event that patients or representatives thereof do not submit required documentation for payment of covered medical costs to social security bodies. Heads of healthcare establishments shall be liable for affixation of their outgoing electronic certification signature and data.
7. Promptly transfer electronic data as prescribed by Article 6 and 7 hereof on the next working day in the event that healthcare establishments close dossiers on health care visit, outpatient or inpatient treatment of a patient on the dates when normal covered healthcare activities are not carried out (e.g. days-off, national or public holidays and lunar New Year holidays).
8. Send electronic data indicating the request for verification and payment of covered healthcare costs and concurrently send electronic data used for management of covered healthcare services if they are capable of doing so.
9. Revise electronic data indicating the request for payment of covered healthcare costs in the event of any inaccuracy of such data, but owe obligations to give clear explanation for such revision and obtain consent from social security bodies.
10. Regulate, provide, use and store health information used for health checkup and medical treatment activities, and payment of covered healthcare costs and other healthcare activities in the network environment existing at healthcare establishments, but ensure that these activities do not breach laws.
Tìm kiếm
Thông tư 48/2017/TT-BYT (Bản Word)