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 information system, rolled out last June, is the optimal solution to ensure transparency and prevent insurance fraud.

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

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

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

The information system can identify the use of a health insurance card multiple times in a short period at different locations, both inside and outside a province. In the final quarter of last year, about 100 cases of wrongful card use over 50 times were discovered – mostly at district-level hospitals and commune-level health stations.

However, multiple plaguing issues still inhibit the effectiveness of the system, Sơn said. For example, many medical facilities still don’t fully update information in the system on a regular basis, and the names of services and drugs are not consistent across related legal documents.

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

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

VNA

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