Regarding the difficulties and inadequacies in the implementation and payment of diagnostic imaging technical services in health insurance (HI) medical examination and treatment, Vietnam Social Security (BHXH) provides some information to clarify the legal basis and principles for implementing appraisal and payment in HI medical examination and treatment according to current regulations.
According to Vietnam Social Security, the appraisal and payment of health insurance medical examination and treatment costs are carried out by the social insurance agency on the basis of fully complying with the provisions of law on medical examination and treatment and law on health insurance.
The Law on Medical Examination and Treatment stipulates that the principle in medical examination and treatment activities is to promptly implement and comply with regulations on technical expertise, and at the same time clearly define the responsibilities of medical examination and treatment facilities in properly implementing technical expertise regulations and relevant legal regulations.
Timelines with professional reference meaning, reality can be adjusted up or down
Decision No. 2775/QD-BYT and Decision No. 2776/QD-BYT dated August 29, 2025 of the Ministry of Health promulgate guidelines on technical procedures in the field of diagnostic imaging and interventional electrophoresis, in which the time for performing techniques is built on the basis of commonality and regularity at medical examination and treatment facilities.
According to these guidelines, the time to perform a diagnostic imaging technique is calculated from the time the patient starts performing the technique until the diagnosis results are available, including the steps: Patient preparation time, scan time, scan reading, diagnostic conclusion. For example, reference time for:
- Regular X-ray of bones and joints or lungs, abdomen: about 6 - 12 minutes;
- Stomach and colon X-ray: about 20 - 30 minutes;
- Abdominal and thyroid ultrasound: about 6 – 15 minutes.
The time milestones mentioned in the guidelines are of professional reference, serving the organization of implementation and building economic - technical norms; in actual implementation, based on clinical developments, patient condition and actual conditions of medical examination and treatment facilities, the technical implementation time may be adjusted to increase or decrease according to the guidance of the Ministry of Health.
No need to "wait enough time" to continue performing the next technical session
The Social Insurance Agency performs appraisal and payment of medical technical service costs based on dossiers, professional procedures and actual implementation at medical examination and treatment facilities, ensuring compliance with legal regulations.
Vietnam Social Security does not issue additional regulations other than current legal documents, and does not require medical examination and treatment facilities to extend the time of performing techniques in a formal manner.
Understanding or applying regulations in the direction of requiring doctors and technicians to "wait enough time" before continuing to perform the next technical session is not consistent with the nature of professional guidance, which may affect the waiting time and benefits of health insurance patients.
To ensure unity in awareness and organization of implementation, Vietnam Social Security proposes that the Ministry of Health continue to review and improve professional and technical guidelines, ensuring they are consistent with the actual implementation and development of medical science and technology, and at the same time create favorable conditions for medical examination and treatment facilities in the process of implementation, thereby ensuring full rights of health insurance participants.
Clause 2, Article 35 of Decree No. 188/2025/ND-CP of the Government stipulates that medical examination and treatment facilities are responsible for complying with the professional guidelines of the Ministry of Health and relevant legal regulations on procurement and bidding, in order to ensure the supply of quality and effective medical technical drugs and services and use the health insurance fund economically and in accordance with regulations.
Circular No. 35/2016/TT-BYT of the Ministry of Health clearly stipulates that medical technical services are paid by the health insurance fund when all conditions are fully met, specifically as follows:
- Approved by competent authorities for implementation at medical examination and treatment facilities;
- Implemented according to professional technical procedures issued by competent authorities;
- Approved by competent authorities for the price of health insurance medical examination and treatment services.
