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New health insurance system prevents fraud

The health insurance medical information system, rolled out last June, is the optimal solution to ensure transparency and prevent insurance fraud.​
New health insurance system prevents fraud ảnh 1Infrastructure and information technology are provided at Cam Le General Hospital in central Da Nang city. (Photo: VNA)

Hanoi (VNA) - The health insurance medical informationsystem, rolled out last June, is the optimal solution to ensure transparencyand prevent insurance fraud.

This consensusof opinion was evident among Government officials at a conference held bythe Vietnam Social Insurance Agency on January 23 to announce its review onimplementation of the health insurance medical information assessment system.

According to reportsdelivered by Pham Luong Son, Deputy Director General of the VSI, 99.5 percentof medical facilities nationwide have been linked to the health insurancemedical information assessment system since its launch, except for 65commune-level health stations in remote areas without electricity access.

The health insurancemedical information assessment system received some 68.9 million dossiersrequesting insurance payments worth 35 trillion VND (1.55 billion USD) in thelast six months of 2016, and another three million requesting insurancepayments of 2 trillion VND (88.6 million USD) in the first month of 2017, thereport said.

The information systemcan identify the use of a health insurance card multiple times in a shortperiod at different locations, both inside and outside a province. In the finalquarter of last year, about 100 cases of wrongful card use over 50 times werediscovered – mostly at district-level hospitals and commune-level healthstations.

However, multipleplaguing issues still inhibit the effectiveness of the system, Sơn said. Forexample, many medical facilities still don’t fully update information in thesystem on a regular basis, and the names of services and drugs are notconsistent across related legal documents.

Nguyen Duc Chung,Chairman of the Hanoi People’s Committee, said all the city’s 673 medicalfacilities had connected to the information system. A number of duplicationsand possible fraud had been exposed as a result, he added.

🌱 Chung also proposedthe idea of piloting electronic health records of all of the city’s residents.-VNA

VNA

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