Insurance claims are always one of the stages that make many first-time users get difficult. Sometimes it takes some rounds to get enough documents to make a claim.

Therefore, this guide on collecting health insurance claims can help saving your time and effort in claiming health insurance.

Insurance Claim Steps:

1. Treated at hospial/ clinic.
2. Collecting medical documents (as instructed below)
3. Fulfil the Claim Form (download at the end of page)
4. Send to TPA (The claim department)
5. Receiving SMS/Email about the claim’s situation.
6. Receiving claim money by transfer/ in cash as requested in Claim Form.

INSTRUCTIONS FOR COLLECTING HEALTH INSURANCE CLAIMS DOCUMENTS

Health insurance claims basically include:

• Claim form (sign, specify full name, title and stamp if the application belongs to the organization) – Claim form can be downloaded at link at the bottom of the page
• Final Charge of hospital – see illustration
• Certificate of treatment or Medical Summary or Medical Report.
• Medical documents: prescriptions, medical examination books, results, test indications, x-rays, discharge papers, surgical certificates, physiotherapy appointments…..
• Payment documents: receipts (up to VND 200,000 if there is no invoice), drug bill, examination fee … see receipt illustration, see invoice illustration
• Other documents: Accident report, driver’s license, vehicle documents (accident case), hospital transfer certificate (transfer case)….

Important notes:

• There is a clinic/hospital seal on the prescription – it can be a round or square seal;  See illustrations
• Some hospitals are exempt from stamping/carpentry on the bill, please see list at the bottom of the page
• For electronic VAT Invoice, it is necessary to submit the medical original documents;  With VAT invoices converted from electronic invoices, copy documents is accepted.
• Receipts of fees over VND 200,000 must be converted into VAT invoices. In case there is no VAT invoice, only pay up to 200,000 VND
• According to the regulations of the Ministry of Health, the time to buy drugs is within 5 days from the date of medical examination.
• The dental treatment card must clearly show: full name of the insured person, date of dental examination and treatment, cause of tooth extraction, filling material, steps to cure marrow, full name of the treating doctor, carpentry of the dental office, hospital on the tooth treatment card.
• The prescription/ medical examination book must clearly show: Full name of the insured person, date of examination, diagnosis, name of drug, number of drugs clearly and must have a signature, full name of the treating doctor, hospital / clinic on the prescription.
• Test results, X-rays … copies can be submitted. Tests that are not related to the disease and tests with normal results are not paid.
• In case of a labor accident at the company, there must be a company seal on the report of the insured.
• In case of traffic accidents: a Vietnamese statutory driver’s license or an approved international driver’s license is required.

It is recommended to use a combination with state health insurance, Afterthat, the claim documents only needs:

• Detailed list of hospital expenses of health insurance
• VAT invoice (for the portion payable for non-payment of health insurance)
• Claim form.

Depending on case by case, specific documents of that type of treatment would be required as below:

1. Hospitalization/surgery (inpatient treatment):

• Claim form.
• Admission/discharge certificate
• Surgical certificate (surgical case)
• Detailed list of hospital fees
• Detailed list of medicines
• Treatment documents: Indications / Ultrasound results, X-rays ….
• Payment documents: VAT invoice for treatment, VAT invoice for drugs.
• Detailed list of medical examination and treatment (if the invoice does not clearly show the examination costs)
• Transfer Certificate (If there is a transfer)
• Other papers…

2. Outpatient examination

• Claim form.
• Prescriptions, medical examination books (with the stamp of the clinic/ hospital)
• Test results, x-rays … (if applicable)
• Payment documents such as invoices (electronic invoices or paper/convertible invoices with round stamps), medical receipts
• Detailed list of medical examination and treatment (if the invoice does not clearly show the examination costs)
• Physiotherapy instruction paper and training schedule slip (if there is a physiotherapy episode)
• Other papers…

3. Dental examination case

• Claim form.
• Dental treatment card.
• Dental film (case of pulp extraction, tooth extraction, fillings .. needs to be filmed)
• Bill for dental treatment.
• Other papers…

Important Notes:

Dental treatment in HO CHI MINH CITY / Ha Noi City: Only cover claim for treatment at Dental Clinicin the direct billing network or dental department in hospitals.

4. Accident Cases

• Claim form.
• Self-declared accident report (stating the date, place, cause, development, and consequences of the accident)
• Driver’s license, vehicle documents (in case of traffic accident)
• Prescriptions, medical examination books (with the stamp of the clinic/ hospital)
• Payment documents: invoices, receipts ..
• Detailed list of medical examination and treatment (if the invoice does not clearly show the examination costs)
• Detailed list of medicines
• Other papers …

5. Deaths

• Death certificate
• Inpatient treatment records (if hospitalized)
• Documents proving inheritance under the Law of Inheritance or having been designated a beneficiary.
• And other papers according to the instructions.

Address to submit BAO VIET claim documents

– Can be submitted directly or sent by Post Services –

ATTN: BAN GIAI QUYET QUYEN LOI BAO HIEM – BAO VIET INSURANCE (TPA BAOVIET)

Address in Hanoi:

• 7 Ly Thuong Kiet Street, Phan Chu Trinh Ward, Hoan Kiem District, Hanoi
• Tel: (84-24) 73009550
• Fax: (84-24) 3 824 5157Email: tpa.hn@baoviet.com.vn
• Hotline 24/7: Branch 3 1900558899

ATTN: BAN GIAI QUYET QUYEN LOI BAO HIEM – BAO VIET INSURANCE (TPA BAOVIET)

Address in Danang:

• 4th Floor, 97 Tran Phu Street, Hai Chau District, Da Nang City
• Phone: (84-24) 73009550
• Fax: (84-236) 3 822 234
• Email: tpa.danang@baoviet.com.vn
• Hotline 24/7: Branch 3 1900558899

ATTN: BAN GIAI QUYET QUYEN LOI BAO HIEM – BAO VIET INSURANCE (TPA BAOVIET)

Address in Ho Chi Minh City:

• 6th Floor, EVNNPT Building – 610 Vo Van Kiet, Cau Kho Ward, District 1, Ho Chi Minh City
• Phone: (84-24) 73009550
• Fax: (84-28) 3520 2666
• Email: tpa.hcm@baoviet.com.vn
• Hotline 24/7: Branch 3 1900558899

If you have any questions, please contact 034764755 for further assistance

Respect!

List of VAT Exempt Hospitals Year 2021.