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LrENNGANH: so Y TE - BAo HIEM xA HQI TiNHKONTUM S6: J556 ILN-SYT-BHXH VIv quy dinh mot s6 n9i dung v@ cong tac kham benh, chua benh bao hiem y t~ nam 2018 CQNG HoA xA HQI cnu NGHiA VI:E:TNAM DQcl~p - TV do - H~nh phuc Kon Tum, ngayd3 thang 12 nam 2017 Kinh giri: - BQ chi huy quan su tinh; - BQ chi huy Su doan 10; - BQtu lenh Binh doan 15; - Cong an tinh Kon Tum; - Ban Bao v~ cham soc sire khoe can bQtinh; - Cong ty TNHH MTV Cao su Kon Tum; - Benh vien Da khoa tinh; - Benh vien Y duoc c6 truyen; - Benh vien Phuc h6i chirc nang; - Benh vien Da khoa khu V\lCNgoc H6i; - Trung tam Y te du phong tinh; - Trung tam Phong chong benh xii hoi; - Trung tam Cham soc sire khoe sinh san; - Trung tam phong chong HIV I AIDS tinh; - Trung tam Y te cac huyen, thanh ph6; - Bao hiem xii hQi cac huyen, thanh ph6. Can cir Thong tu s6 14/2014/TT-BYT ngay 14/4/2014 cua BQ Y te v~ viec quy dinh chuyen tuyen gitra cac co sa kham benh, chua benh (sau day goi la Thong tu s6 14/2014/TT-BYT); Can cu Thong tu s6 40/2015/TT-BYT ngay 16/1112015 cua BQ Y te v~ vi~c huang dfin dang kY kham b~nh, chua b~nh ban d~u va chuy~n tuyen kham b~nh, chua b~nh bao hi~m y te (sau day gQi 1aThong tu s6 40/20 15/TT-BYT); Can cu Thong tu lien tich s6 4112014/TTLT-BYT-BTC ngay 24/11/2014 cua lien BQ Y te - BQ Tai chinh huang dfin th\lc hi~n bao hi~m y te (sau day gQi 1aThong tu lien tich s6 41/20 14/TTLT-BYT-BTC); Lien nganh Sa Y te - Bao hi~m xii hQi (BHXH) tinh Kon Tum quy dinh m9t s6 nQi dung v~ kham b~nh, chua b~nh (KCB) bao hi~m y te (BHYT) nam 2018, C\lth~ nhu sau:

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LrENNGANH:soY TE - BAo HIEM xA HQITiNHKONTUM

S6:J556 ILN-SYT-BHXHVIv quy dinh mot s6 n9i dung v@cong tac kham benh, chua benh

bao hiem y t~ nam 2018

CQNG HoA xA HQI cnu NGHiA VI:E:TNAMDQcl~p - TV do - H~nh phuc

Kon Tum, ngayd3 thang 12 nam 2017

Kinh giri:- BQ chi huy quan su tinh;- BQchi huy Su doan 10;- BQtu lenh Binh doan 15;- Cong an tinh Kon Tum;- Ban Bao v~ cham soc sire khoe can bQ tinh;- Cong ty TNHH MTV Cao su Kon Tum;- Benh vien Da khoa tinh;- Benh vien Y duoc c6 truyen;- Benh vien Phuc h6i chirc nang;- Benh vien Da khoa khu V\lCNgoc H6i;- Trung tam Y te du phong tinh;- Trung tam Phong chong benh xii hoi;- Trung tam Cham soc sire khoe sinh san;- Trung tam phong chong HIV IAIDS tinh;- Trung tam Y te cac huyen, thanh ph6;- Bao hiem xii hQi cac huyen, thanh ph6.

Can cir Thong tu s6 14/2014/TT-BYT ngay 14/4/2014 cua BQ Y te v~viec quy dinh chuyen tuyen gitra cac co sa kham benh, chua benh (sau day goila Thong tu s6 14/2014/TT-BYT);

Can cu Thong tu s6 40/2015/TT-BYT ngay 16/1112015 cua BQ Y te v~vi~c huang dfin dang kY kham b~nh, chua b~nh ban d~u va chuy~n tuyen khamb~nh, chua b~nh bao hi~m y te (sau day gQi 1aThong tu s6 40/20 15/TT-BYT);

Can cu Thong tu lien tich s6 4112014/TTLT-BYT-BTC ngay 24/11/2014cua lien BQ Y te - BQ Tai chinh huang dfin th\lc hi~n bao hi~m y te (sau day gQi1aThong tu lien tich s6 41/20 14/TTLT-BYT-BTC);

Lien nganh Sa Y te - Bao hi~m xii hQi (BHXH) tinh Kon Tum quy dinhm9t s6 nQi dung v~ kham b~nh, chua b~nh (KCB) bao hi~m y te (BHYT) nam2018, C\lth~ nhu sau:

,'.

I. DANG KY KCB BHYT BAN DAu1.D8i vOi thanh ph8 Kon Tum:- D6i nrong tham gia BHYT la ngiroi thuoc hQgia dinh ngheo; c?n ngheo;

nguoi dan tQcthieu s6 dang sinh song tai vung c6 di6u kien kinh t€ - xa hQikh6khan; ngiroi dang sinh song tai vung co di6u kien kinh t~ - xa hQidac biet kh6khan; ngiroi thuoc hQgia dinh lam nong nghiep, lam nghiep, ngu nghiep; ngiroitham gia BHYT thea hQgia dinh; h9C sinh, sinh vien; tre em duoi 6 tu6i, noidang kY KCB ban dAudiroc phan b6 cu th€ nhu sau:

+ T6 dan ph6 10, 12, 13 va 14 thuoc phuong Quyet Thing; t6 dan ph6 8,9, 10, 13, 14, 15 va thon Plei Don, thon Plei Tonghia thuoc phuong QuangTrung; t6 dan ph6 1, 7 va 1° thuoc phuong Duy Tan; h9C sinh Truong Trungh9Cph6 thong Kon Tum, Truong Trung hoc co so Nguyen Hue va Truong Ti€uh9CTHSP Nguy Nhu Kon Tum dang kY KCB ban dAutai Benh vien Da khoatinh.

+ T6 dan ph6 3, 5 thuoc phirong Truong Chinh; t6 dan ph6 3, 6 thuQcphuang Thing Lgi; h9C sinh Truang Ti€u h9c Quang Trung, Truong Ti€u h9CPhan Chu Chinh, Truang Ti€u h9CTrAnPhti va Truong Trung h9Cph6 thong(THPT) Duy Tan dang kY KCB ban dAut?i B~nh xa Su doan 10 (Ti€u doan 24).

+ T6 dan ph6 5, thon Kon Tu 2 thuQcphuong Truang Chinh; t6 dan ph63, 9 thuQcphuang Duy Tan dang kY KCB ban dAut?i Phong kham Da khoatrung tam, thanh ph6 Kon Tum.

+ T6 dan ph6 1 va 2 thuQcphuong TrAnHung D?o, t6 dan ph6 5 thuQcphuang Le Lgi; h9C sinh Truang Ti€u h9C Nguyen Trai, Truong Ti~u h9CNguyen Vi€t Xuan, Truang Ti~u h9CLuang Th€ Vinh va Truong Trung h9CCo'sO'(THCS) Chu Van An dang kY KCB ban dAut?i B~nh xa BQchi huy quan S\Itinh.

+ T6 dan ph6 3, 4, 5 thuQcphuang Th6ng Nhfrt; sinh vien Truang Caod~ng su ph?m; h9Csinh Truang THPT chuyen Nguyen TfrtThanh, Truang Ti€uh9CVo Thi Sau va Truang Ti€u h9CNgo Quy6n dang kY KCB ban dAut?i B~nhvi~n Phl,lch6i chuc nang tinh Kon Tum.

+ Thon Plei RO'Hai 1, thon Plei RO'Hai 2 thuQcphuang Le Lgi; thon DakBrong, thon Dien Trung thuQcxa Chu Hreng; h9C sinh Truang THPT Le Lgi,Truong THCS Nguyen Thi Minh Khai, Truong THCS Le Lgi, Truong Ti€u h9CNguyen Hi6n dang kY KCB ban dAut?i B~nh vi~n Y dugc c6 truy6n tinh KonTum.

+ Con l?i cac dia ban khac, nO'idang kY KCB ban dAula Tr?m Y t~ (TYT)xa, phuang thuQc Trung HimY t~ (TTYT) thanh ph6 Kon Tum. D6i v6i nguoi

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co the BHYT thuoc phuong Ngo May noi dang Icy KCB ban d~u hi Phong khamDa khoa khu vue (PKDKKV) Ngo May.

- D6i voi cac d6i tuong cung tham gia BHXH, BHYT do BHXH tinh,BHXH thanh ph6 Kon Tum quan ly thu; huu tri, nguoi co cong voi each mang,Bao tro xiI hQi va cac d6i tuong con lai noi dang Icy KCB ban d~u la Benh vienDa khoa tinh, Benh xa BQ chi huy quan S1,l tinh, Benh xa Su doan 10, Benh vienPhuc h6i chirc nang va Benh vien Y diroc c6 truyen tinh.

2. D8i v6i huy~n NgQe H8i:

- NO'i dang Icy KCB ban d~u d6i v6i ngiroi thuoc hQ gia dinh ngheo; c~nngheo; nguoi dan tQc thieu s6 dang sinh song tai vung co di€u kien kinh t€ - xiIhQi kho khan; nguoi dang sinh s6ng tai vung co di€u kien kinh t€ - xiI hQi d~cbiet kho khan; tre em du6i 6 tuoi; ngiroi thuoc hQgia dinh lam nang nghiep, lamnghiep, ngu nghi~p; nguoi tham gia BHYT thea hQ gia dinh; h<;>csinh, sinh vienla TYT xiI, thi td.n. D6i v6i cac xiI, thi tr~n vira co TYT vila co PKDKKV, nO'idang Icy KCB ban d~u cua cac nh6m d6i tuQ'ng neu tren la PKDKKV.

- Nguoi tham gia BHYT t~i than 1, 2, 3, 4 xiI Dak Kan huy~n Ng<;>cH6i,nO'idang Icy KCB ban d~u la B~nh xa Cang ty 732 - Binh doan 15.

- NO'i dang Icy KCB ban d~u cua cac d6i tuQ1lg cung tham gia BHXH,BHYT; huu tri va cac d6i tuQ'ng con l~i la B~nh vi~n Da khoa khu Vl,l'C

(BVDKKV) Ng<;>cH6i ho~c PKDKKV ho~c TYT xiI nO'inguoi do cu tru.

3.•D8i vcri eae huy~n eon l~i:

- NO'i dang Icy KCB ban d~u d6i v6i nguoi thuQc hQ gia dinh ngheo; c?nngheo; nguoi dan tQc thi€u s6 dang sinh s6ng t~i vung c6 di€u ki~n kinh t€ - xiIhQi kh6 khan; nguoi dang sinh s6ng t~i vung c6 di€u ki~n kinh t€ - xiI hQi d~cbi~t kh6 khan; tre em du6i 6 tu6i; nguoi thuQc hQgia dinh lam nang nghi~p, lamnghi~p, ngu nghi~p; nguoi tham gia BHYT thea hQgia dinh; h<;>csinh, sinh vien:La TYT cac xiI, nO'inguoi d6 cu tm ho~c dang thea h<;>ca cac truong dung chantren dia ban cac xiI do. D6i v6i cac xiI vira co TYT vila co PKDKKV, nO'idangIcy KCB ban d~u cua cac nhom d6i tUQ1lgneu tren la PKDKKV nO'inguoi d6 cutm ho~c dang thea h<;>ca cac truang dung chan tren dia ban cac xiI do.

- Nguoi tham gia BHYT t~i xiI Ma Rai huy~n Sa Th~y g~n B~nh xa khuV1,lC Ma Rai - Binh doan 15 duQ'c dang Icy KCB ban d~u t~i B~nh xa khu Vl,l'C MaRai - Binh doan 15.

- Nguoi tham gia BHYT t~i than Mang Den xiI Dak Long huy~n KonPlang, dang Icy KCB ban d~u t~i TTYT huy~n Kon Plang.

- NO'i dang Icy KCB ban d~u cua cac d6i tuQ1lg cung tham gia BHXH,BHYT; huu tri va cac d6i tUQ'ngcon I~i Ia TTYT huy~n nO'inguoi do cu tru.

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4. DBi tueng do Ban bao v~ sfre khoe can bQ tinh quan ly: D6i nrongthuoc dien duoc Ban bao v~ sire khoe can b<)tinh quan Iy duoc dang ky KCBban d~u tai Phong kham thuoc Ban bao v~ cham soc sire khoe can b<)tinh hoacco sa KCB quy dinh tai Di~u 8 va khoan 1, khoan 2 dieu 9 Thong tu s640/2015/TT- BYT.

5. Rieng dBi vOi cac vimg ~iap ranh tren dja ban tinh: Ngiroi tham gi~BHYT duoc dang Icy KCB ban dau tai cac TYT xii, PKDKKV, cac co sa y tetuyen huyen g~n nhftt so voi noi cu tru cua nguoi tham gia BHYT.

6. DBi vOi Cong ty TNHH MTV Cao su Kon Tum: NO'idang ky KCBban d~u cua can b<),cong nhan vien chirc thuoc Cong ty la co sa KCB tnrc thuocCong ty va cac co sa y t€ tuyen huyen, tuyen xii g~n nhftt so vai nO'icu tm cuanguai tham gia BHYT.

7. Cae trU'img hQ'pkhae:a) [)6i vai xii [)ak Long, huy¢n [)ak Hiz:

- NO'idang kY KCB ban d~u d6i vai nguai tham gia BHYT cu tm tren diaban thon 1, thon 2, thon 11va thon 12 thu<)cxii Dak Pxy truac day (nay thu<)cxiiDak Long) la TYT xii Dak Pxy.

- NO'idang kY KCB ban d~u d6i vai nguai tham gia BHYT cu tm tren diaban thon 4 va thon 5 thu<)cxii Dak Hring truac day (nay thu<)cxii Dak Long) laPKDKKV Dak Hring.

b) Thay d6i nai dang kY KCB ban ddu: Nguai tham gia BHYT, duQ'ch,rachQnnO'idang Icy KCB ban d~u thea quy dinh cua Lu~t BHYT do v~y vi~c thayd6i nO'idang Icy KCB ban d~uva phan b6 s6 lugng the BHYT v~ cac cO'So' KCBneu tren phai dung quy dinh va dam bao phu hqp vai nguy~n vQng cua nguaitham gia BHYT. Nguai tham gia BHYT duQ'cthay d6i nO'idang kY KCB band~uvao d~um6i quy.

c) Cae trueing h(Jp khae: Nguai t~m tru co thai h~n ho~c lam vi~c tren diaban huy~n, thanh ph6 khong co cO'sa KCB tuy€n xii, tuy€n huy~n va tuO'ngduO'ngho~c cac cO'sa KCB do khong dap ung duQ'cvi~c KCB ban d~u chonguai tham gia BHYT, duQ'cdang kY KCB ban d~u t~i cO'sa KCB tuy€n tinh vatuang duang thea huang d~n cua cO'quan BHXH.

8. KCB ngay nghi thfr 7, ehii nh~t, ngay l~, t~t: Thvc hi~n thea quydinh t~i Thong tu lien tich s6 16/2015/TTLT-BYT-BTC ngay 0217/2015 cua lienB<)Y t€ - B<)Tai chinh v€ vi~c sua d6i Khofm 5 Di~u 13 Thong tu lien tich s64112014/TTLT-BYT-BTC ngay 24/1112014 cua lien B<)Y t€ - B<)Tai chinhhuang d~n thvc hi~n BHYT. Vi~c thvc hi~nKCB vao ngay nghi thu 7, chu nh~t,ngay I€, t€t phai duQ'cghi C\l th~ trong hQ'pd6ng KCB BHYT thai gian lam vi~cngoai gia trong tu~n va phai tuan thu cac quy dinh hi~n hanh cua Nha nuac v~thai gian lam them gia.

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II. THO-TUC KCB BHYT, CHUYEN TUYEN KCB BHYT

1. Thii tuc KCB BHYT dai vo; tre em dU'O;6 tu8i:

Truong hQ'ptre em duoi 6 tu6i d€n KCB khong xudt trinh th~ BHYT v~ndiroc hirong quyen IQ'i cua ngiroi tham gia BHYT nhung phai xuat trinh giaychirng sinh hoac gidy khai sinh; tnrong hop phai dieu tri ngay sau khi sinh rnachua c6 gidy chimg sinh thi thu tnrong co So' y t€ va cha (me) hoac ngiroi giamhQ cua tre kY xac nhan vao h6 sa benh an d~ lam din cu thanh toan theo quydinh tai Khoan 2, Di€u 13 Thong tu lien tich s6 4112014/TT-BYT-BTC va chiutrach nhiem v€ viec xac nhan nay.

Co So' KCB c6 trach nhiem cung cdp ban photocopy gidy to thay th€ theBHYT kern theo Danh sach tre em duoi 6 tu6i di KCB BHYT khong trinh the d€nghi thanh toan (m~u s6 01 kern theo Cong van s6 199/BHXH-GDBHYT ngay27/8/2015 cua BHXH tinh Kon Tum) khi thanh toan voi co quan BHXH.

2. Dai vo; mQt sa b~nh m~n Hnh: Thl,IChi~n theo quy dinh t~i Di~m d,Khmin 1, Di€u 12 Thong tu s6 40/2015/TT-BYT; Danh m\lC cac b~nh, nh6mb~nh va cac truOng hqp duQ'c sir d\lng gidy chuy~n tuy€n trong nam duang lichquy dinh t~i Ph\ll\lc s6 01 ban hanh kem theo Thong tu s6 40/2015/TT- BYT.

3. TrU'irng hVp chuy~n tuy~n giii'a cac cO' sO' KCB tren cac dja bimgiap ranh: TYT cac xa, phuOng va PKDKKV thuQc TTYT thanh ph6 KonTum; TYT xa Dak La, xa NgQCReo thuQChuy~n Dak Ha; TYT xa Dak To RethuQc huy~n Kon R~y du<),cquy€n gi6i thi~u nguoi b~nh BHYT vuqt qua khanang K~B len th~ng B~nh vi~n Da khoa tinh' B~nh vi~n Ph\lc h6i chuc nang(theo chuyen khoa Ph\lc h6i chuc nang), B~nh vi~n Y duQ'c c6 truy€n (theochuyen khoa Y duQ'c c6 truy€n), Trung tam Cham s6c suc kh6e sinh san, TrungHim Phong ch6ng b~nh xa hQi va Trung tam Y t€ dl,Iphong (theo tung chuyenkhoa) khong phai qua TTYT huy~n, thanh ph6.

4. Cac CO'sO'KCB khac:

- TTYT cac huy~n, B~nh xa BQ chi huy quan Sl,Itinh, B~nh xa Su doan 10va TTYT di€u duang Cong ty TNHH MTV Cao su Kon Tum gi6i thi~u nguoib~nh BHYT vuqt qua kha nang KCB v€ B~nh vi~n Da khoa tinh, B~nh vi~nPh\lc h6i chuc nang (theo chuyen khoa Ph\lc h6i chuc nang), B~nh vi~n Y duQ'cc6 truy€n (theo chuyen khoa Y duQ'c c6 truy€n), Trung tam Cham s6c Cham s6csuc kh6e sinh san, Trung tam Phong ch6ng b~nh xa hQi va Trung tam Y t€ dl,Iphong (theo tUng chuyen khoa).

- B~nh xa khu Vl,ICMo Rai - Binh doan 15, TTYT huy~n Ia H'Drai gi6ithi~u nguoi b~nh BHYT vuqt qua kha nang v€ B~nh vi~n Da khoa tinh, B~nhvi~n Ph\lc h6i chuc nang (theo chuyen khoa Ph\lc h6i chuc nang), B~nh vi~n YduQ'c c6 truy€n (theo chuyen khoa Y duQ'c c6 truy€n), Trung tam Cham s6cCham s6c suc kh6e sinh san, Trung tam Phong ch6ng b~nh xa hQi va Trung tam

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Y t€ du phong (theo nrng chuyen khoa) hoac cac co sa y t€ da diroc thoa thuanthea Bien ban him viec ngay 30/7/2015 gitra Sa Y t€ va BHXH tinh Kon Tumvoi Sa Y t€ va BHXH tinh Gia Lai v€ chuyen tuyen KCB va thanh toan KCBBHYT.

- Benh vien Da khoa tinh Kon Tum, d6i voi cac dich vu ky thuat chuatrien khai duoc chuyen tuyen ky thuat d€n cac co sa y t€ da ducc thoa thuanthea Bien ban lam viec ngay 30/7/2015 gitra Sa Y t€ va BHXH tinh Kon Tumvoi Sa Y t€ va BHXH tinh Gia Lai v€ chuyen tuyen KCB va thanh toan KCBBHYT.

- Nguoi benh co the BHYT mang rna noi sinh song ghi tren the co Icy hieula Kl, K2 khi tu di KCB khong dung tuyen duoc quy BHYT thanh toan chi phiKCB nOi tru tai benh vien tuyen tinh, tuyen trung irong voi mire huang thea quydinh.

5. Mftu gi§y gi6'i thi~u chuyen vi~n: Cac tnrong hop chuy€n tuy€nchuyen mon ky thu~t k€ ca chuy€n tuy€n chuyen mon ky thu~t ttl cac TYT xa,ca sa y t€ cua ca quan, dan vi, truang hQc phai su d\mg gi~y chuy€n tuy€n theamfru duqc ban hanh t~i ph\l l\lc s6 1 kern thea Thong tu s6 14/2014/TT-BYTngay 14/4/2014 cua BOY t€.

6. Thong tuy~n KCB t~i cac cO' sO' y t~ tuy~n huy~n trong dja himtinh:

a) Theo khoan 4 Ui€u 22 Lu~t BHYT; Til ngay 0110112016, nguai thamgia BHYT dang KCB ban dAu t~i TYT xa ho?c PKUKKV ho?c b~nh vi~n tuy€nhuy~n duqc quy€n KCB BHYT t~i TYT xa ho?c PKUKKV, ho?c b~nh vi~ntuy€n huy~n trong cung dia ban tinh va duqc huang cac quy€n lqi, muc huangthea quy dinh t~i Khoan 1 Ui€u 22 Lu~t BHYT.

b) Theo Ui€m c, Khofm 3 di€u 22 Lu~t BHYT; Nguai tham gia BHYTdang Icy KCB ban dAu t~i ca sa KCB tuy€n tinh, tuy€n Trung uang va theBHYT khong dang ky KCB ban dAu t~i tinh Kon Tum, duqc KCB BHYT t~ib~nh vi~n tuy€n huy~n va duqc huang cac quy€n lqi, muc huang thea quy dinht~i Khmin 1 Ui€u 22 Lu~t BHYT.

III. H<}PDONG KCB BHYT

1.D6i vO'ithimh ph6 Kon Tum:

- BHXH tinh Icy hqp d6ng KCB BHYT v6i B~nh vi~n Ua khoa tinh, B~nhvi~n Y duqc c6 truy€n, B~nh vi~n Ph\lc h6i chuc nang, Trung Him Phong ch6ngb~nh xa hOi, Trung Him Cham soc suc khoe sinh san, Trung Him Y t€ d\l phong,Ban bao v~ cham soc suc khoe can bO tinh, TTYT di€u du5ng C6ng ty TNHHMTV Cao su Kon Tum, B~nh xa BO chi huy guan S\l tinh, B~nh xa Su doan 10,B~nh xa C6ng an tinh va Trung tam phong chong HIV1AIDS tinh.

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- BHXH thanh ph6 Kon Tum true tiSp kY hop d6ng KCB ngoai tni voiTTYT thanh pho Kon Tum d€ trien khai cong tac KCB BHYT tai cacPKDKKV, TYT cac xa, plnrong,

2. D6i v6'i huyjn Ngoc RBi: BHXH huyen true tiSp ky hop d6ng voiBVDKKV Ngoc H6i, TTYT huyen Ngoc H6i, Benh xa Cong ty 732 - Binh doan15 d€ trien khai cong tac KCB BHYT tai cac co So'KCB nay.

3. D6i v6'i huy~n Sa Th§y: BHXH huyen true tiSp ky hop d6ng voiTTYT huyen, Benh xa QDY khu V\fCMo Rai - Binh doan 15 d€ trien khai congtac KCB BHYJ: tai tai cac co So'KCB nay. .

4. D6i v6'i ca~ huyen con l~i: BHXH cac huyen tnrc tiep ky hop d6ng voiTTYT cac huyen d~ trien khai cong tac KCB BHYT tai TTYT huyen, PKDKKVva TYT cac xa, thi tran.

Vi~c ky hop d6ng KCB BHYT nam 2018 phai diroc hoan t~t tru6c ngay31112/2017. S6 nguai c6 the BHYT '!_angky KCB ban dAuva quy KCB BHYTtl;lirung cO'So'KCB tl;lm tinh thea mau C81-HD quy 3/2017 de lam can Cll kYhqp d6ng nam 2018 (s6 nguai co the BHYT, s6 quy KCB tlu9'c tliJu chinh himgquy thea thong baa cua BHXH tinh Kan Tum). Chi phi binh quan lam can Clltinh trAn da tuySn dSn se duQ'cxac dinh va kY b6 sung ph\l l\lc hqp d6ng sau khic6 bao cao quySt toan chi phi KCB BHYT quy 4/2017.

IV. UNG DVNG CONG NGHt THONG TIN

CO'quan BHXH va cO'So'KCB ph6i hqp dAyml;lnh llng d\lng cong ngh~thong tin trong KCB va thanh quySt toan chi phi KCB BHYT. Cac cO'So'KCBc6 trach nhi~m khAn truO'ng hoan thi~n phAn m€m quan ly b~nh vi~n, dam baochuAnva dinh dl;lngdAu ra su d\lng trong quan ly, giam dinh va thanh quySt toanchi phi KCB BH~T thea QuySt djnh s6,4210IQD-BYT ngaY,20/9/2017 cua B9Y teoTh\fc hi~n day dfr li~u len Cong tiep nh~n dfr li~u H~ thong thong tin giamdinh BHYT kip thai ngay khi b~nh nhan ra vi~n, kSt thuc dqt KCB; cu6i ngaylam vi~c, cO'So'KCB truy c~p C6ng tiSp nh~n, ki€m tra, xac th\fc tinh chinh xaccua dfr li~u, gui dfr li~u giam dinh thea dung quy dinh.

V. cAc PHV LVC REM THEO

- Ph\ll\lc I: Danh sach cO'So'y tS nh~n dang kY KCB BHYT ban dAunam2018.

- Ph\ll\lc II: Danh sach cO'So'KCB kY hqp d6ng KCB BHYT nam 2018.

VI. TO cHirc THVC HItN

Cac n9i dung quy dinh tl;li Cong van nay duQ'c th\fc hi~n tu ngay01/01/2018. Cong van nay thay thS Cong van lien nganh s6 3414/LN-SYT­BHXH ngay 12/12/2016 va Cong van lien nganh s6 45/LN-SYT-BHXH ngay06/0112017 cua lien nganh So' Y tS - BHXH tinh.

7

Lien nganh Sa Y t€ - BHXH tinh yeu cAu cac don vi nghiem tuc trien khaithuc hien, Trang qua trinh thuc hien neu co kho khan, virong m~c d€ nghi cac, ' ," ,. ') ,don vi phan anh bang van ban ye SC(Y, te ya BHXH tinh de xem xet, phoi hopgiai quy€t kip thoi.'. .... _ . , ,

GIAM DOC BHXH TiN~'1-;"

Trin Van Ll}"c Trin AiNainh~n:- Nhir tren;- BHXH Vi~t Nam (b/c)- Vu BHYT BQ Y t~ (b/c);- UBND tinh (b/c);- So' LD,TB&XH;- So' Giao due va Dao tao;- UBND va PYT cac huyen, thanh ph6;- UBND cac xli, phirong, thi tran;- Lanh dao So' Y t~va BHXH tinh;- Cac phong thuoc So' Y t~va BHXH tinh;- LUll: VT S6 Y t~,VT BHXH tinh,

8

-~y.~.~fl'!~·~~~

DAN'A~Md~I'1YTtDANG KY KHAM C] ~ ~~:E:~1i1AJqDAu BHYT NAM 2018

~~~~~ I(O~0--..

HangS8 TTMil coo .l.

theo Ten CO'scYKCB BHYT Tuyen cO'scY Ghi chtiTT scYKCB CMKTmuc KCBPhong kham Ban bao v~

1 A cham soc sue khoe can bi) 62010 Tuyen 2 2tinh

B cAc B:¢NH VI_¢N2 1 Benh vien Da khoa tinh 62001 Tuyen 2 23 2 Benh vien Phuc h6i chirc nang 62058 Tuyen 2 34 3 Benh vien Y diroc c6 truyen 62134 Tuyen 2 3

5 4 Benh vien Da khoa khu V\lC62127 Tuyen 3 3Ngoc H6i

C cAc HUY_¢N, THANH PHOI Thanh ph8 Kon Tum

6 1 Benh xa BQ chi huy quan sir62124 Tuyen 3 CHtinh

7 2 Benh xa Su dean 10 (D24FI0) 62126 Tuyen 3 CH

8 3 Trung tam Y t€ Cong ty TNHH62011 Tuyen 3 CHMTV Cao su Kon Tum

Nh~nDKban

9 4 Benh xa Cong an tinh 62141 Tuyen 3 CH d~u choCB,CSthuocCA tinh

10 5 PKDK trung tam, TP Kon Tum 62129 Tuyen 3 CH11 6 PKDKKV Ng6 May 62034 Tuyen 3 CH12 7 Tram Y t€ xa Chu Hreng 62014 Tuyen 4 CH13 8 Tram Y t€ xa Hoa Binh 62015 Tuyen 4 CH14 9 Tram Y t€ phuong Th&ngNhftt 62016 Tuyen 4 CH15 10 Tram Y t€ xa Dak Bla 62017 Tuyen 4 CH

16 11 Tr~m Y t€ phuOng Quang62018 Tuy€n 4 CHTrung

17 12 Tram Y t€ xa Dak Ro Wa 62019 Tuyen 4 CH18 13 Tram Y t€ xa Ia Chim 62020 Tuyen 4 CH

9

.'.

l"''' ,~ ,

sA TT .\. -: .. , H~ng" Ma co I.

theo Ten co scYKC.$ BHTe ' . TuyencO'scY Ghi clniTT ; lI4oti. ~:scYKCB CMKT KCBmuc . ~\ ~~"'¥ ':..r

19 14 Tram Y t~ xa Vinh ~ang .Tuyen 462021 CH

20 15 Tram y t~ xa Ngok Bay 62022 Tuyen 4 CH21 16 Tram Y t~ xa Kroong 62023 Tuyen 4 CH22 17 Tram Y t~ phuong Le Loi 62024 Tuyen 4 CH23 18 Tram Y t~ phuong Duy Tan 62025 Tuyen 4 CH

24 19Tram Y t~ phuOng Truong

62026 Tuy~n 4Chinh CH

25 20 Tram Y t~ xa Dak Cam 62027 Tuyen 4 CH26 21 Tram Y t~ phirong Thang Loi 62028 Tuyen 4 CH

27 22Tram Y t~ phirong Trftn Hung

62029 Tuyen 4 CHD~o

28 23Tram Y t~ phuOng Quyet

62030 Tuyen 4 CHTh~ng

29 24 Tram Y t~ phirong Nguyen Trai 62032 Tuyen 4 CH30 25 Tram Y t~ xa Dean K~t 62033 Tuyen 4 CH31 26 Tr~m Y tS xa Dak Nang 62128 Tuyen 4 CH

II Huyen BakHfl32 1 TTYT huyen Dak Hit 62007 Tuyen 3 333 2 PKDKKV Ngoc Wang 62072 Tuyen 3 CH34 3 PKDKKV Dak Hring 62133 Tuyen 3 CH35 4 Tram Y t~ thi tr~n Dak Hit 62092 Tuyen 4 CH36 5 Tr~m Y t~ xa Dak Pxi 62093 Tuy~n 4 CH37 6 Tr~m Y tS xa Dak Vi 62095 Tuy~n 4 CH38 7 Tr~m Y tS xa Dak Mar 62096 Tuy~n 4 CH39 8 Tr~m Y tS xa Ng<,>cReo 62098 Tuy~n 4 CH40 9 Tr~m Y t~ xa Hit Mon 62099 Tuy~n 4 CH41 10 Tr~m Y tS xa Dak La 62100 Tuy~n 4 CH42 11 Tr~m Y tS xa Dak Ng<,>k 62146 Tuy~n 4 CH

Thvchi~n sau

43 12 Tr~m Y t~ xa Dak Long Tuy~n 4 CH khidu<)'cciip rnaKCB

III Huy~n Bak To44 1 TTYT huy~n Dak To 62004 Tuy~n 3 345 2 Tr~m Y t~ thi tr~n Dak To 62057 Tuy~n4 CH

10

sa TTMil coo I. H,ng

theo Ten coosO'KCB BHYT Tuyen coosO' Ghi chuTT sO'KCB CMKTmuc KCB46 3 Tram Y t~ xa Ngoc Tu 62066 Tuyen 4 CH47 4 Tram Y t~ xa Van Lem 62067 Tuyen 4 CH48 5 Tram Y t~ xa Kon Dao 62068 Tuyen 4 CH49 6 Tram Y t~xa Tan Canh 62069 Tuy~n 4 CH50 7 Tram Y t~ xa Dien Binh 62070 Tuyen 4 CH51 8 Tram Y t~ xa po Ko 62071 Tuyen 4 CH52 9 Tr~m Y t~ xa Dak RaNga 62074 Tuyen 4 CH53 10 Tram Y t~xa Dak Tram 62075 Tuyen 4 CH

IV Huyen Tu MooRang54 1 TTYT huyen Tu Ma Rong 62013 Tuyen 3 355 2 PKDKKV Tu Ma Rong 62073 Tuyen 3 CH56 3 PKDKKV Dak Ra Ong 62139 Tuyen 3 CH57 4 Tram Y t~ xa Ngok Lay 62112 Tuyen 4 CH58 5 Tram Y t~ xa Dak Na 62113 Tuyen 4 CH59 6 Tram Y t~ xa Mang Ri 62114 Tuyen 4 CH60 7 Tram Y t~ xa Ngok Yeu 62115 Tuyen 4 CH61 8 Tram Y t~ xa Dak Sao 62116 Tuyen 4 CH62 9 Tram Y t~xa Te Xang 62119 Tuyen 4 CH63 10 Tram Y t~ xa Van Xuoi 62120 Tuyen 4 CH64 11 Tram Y t~ xa Dak To Kan 62121 Tuy~n 4 CH

V Huy~n NgQc HAi

65 1 B~nh xli Quan dan y thu9c62810 Tuy~n 3 CHCong ty 732IBinh doan 15

66 2 PKDKKV Dak Dl,lc 62063 Tuy~n 3 CH67 3 Tr~mY t~ thj tr~n Plei C~n 62049 Tuy~n 4 CH68 4 Tr~m Y t~ xa Dak Ang 62050 Tuy~n 4 CH69 5 Tr~m Y t~ xa Dak Nong 62052 Tuy~n 4 CH70 6 Tr~mY t~ xa Dak Xu 62053 Tuy~n 4 CH71 7 Tr~mY t~xa Dak Kan 62054 Tuy~n 4 CH72 8 Tr~m Y t~ xa Po Y 62055 Tuy~n 4 CH73 9 Tr~mY t~xa Sa Loong 62056 Tuy~n 4 CH

VI Huy~n Bilk Glei74 1 TTYT huy~n Dak Glei 62002 Tuy~n 3 375 2 PKDKKV Dak Mon 62061 Tuy~n 3 CH76 3 PKDKKV Muong Hoong 62062 Tuy~n 3 CH

11

, ~ J

s6 TT Mil coo $. H~.lDgtheo Ten coosO'KCB BHYT Tuyen coosO' Ghi chuTT so-KCB CMKTmuc KCB

77 4 Tram Y t€ thi tr§.nDak Glei 62037 Tuyen 4 CH78 5 Tram Y t€ xa Dak BI6 62038 Tuyen 4 CH79 6 Tram Y t€ xa Dak Man 62039 Tuyen 4 CH80 7 Tram Y t€ xa Dak Nhoong 62040 Tuyen 4 CH81 8 Tram Y t€ xa Dak Pet 62041 Tuyen 4 CH82 9 Tram Y t€ xa Dak Choong 62042 Tuyen 4 CH83 10 Tram Y t€ xa X6p 62043 Tuyen 4 CH84 11 Tram Y t€ xa Ngoc Linh 62045 Tuy€n 4 CH85 12 Tram Y t€ xa Dak Long 62046 Tuyen 4 CH86 13 Tram Y t€ xa Dak Kroong 62047 Tuyen 4 CH

VII Huyen Kon R§y87 1 TTYT huyen Kon Rfiy 62008 Tuyen 3 388 2 PKDKKV Dak Rve 62137 Tuyen 3 CH89 3 Tram Y t€ xa Dak K6i 62086 Tuyen 4 CH90 4 Tram Y t€ xa Dak To Lung 62087 Tuyen 4 CH91 5 Tram Y t€ xa Dak Ruong 62088 Tuyen 4 CH92 6 Tram Y t€ xa Dak Pne 62089 Tuyen 4 CH93 7 Tram Y t€ xa Dak To Re 62090 Tuyen 4 CH94 8 Tram Y t€ xa Tan L~p 62091 Tuyen 4 CH

VIII Huyen Kon Plong95 1 TTYT huyen Kon Piong 62006 Tuyen 3 396 2 PKDKKV Dak Ring 62064 Tuy€n 3 CH97 3 Tr:;tmY t€ xa Dak Nen 62076 Tuy€n 4 CH98 4 Tr:;tmY t€ xa Mang Buk 62078 Tuy€n 4 CH99 5 Tr:;tmY t€ xa Dak Tang 62079 Tuy€n 4 CH100 6 Tr:;tmY t€ xa Ng9c Tem 62080 Tuy€n 4 CH101 7 Tr:;tmY t€ xa PO' E 62081 Tuy€n 4 CH102 8 Tr:;tmY t€ xa Mang Canh 62082 Tuy€n 4 CH103 9 Tr:;tmY t€ xa Dak Long 62083 Tuy€n 4 CH104 10 Tr:;tmY t€ xa Hi€u 62084 Tuy€n 4 CH

IX Huy~n Sa Th§y105 1 TTYT huy~n Sa ThAy 62005 TuySn 3 3106 2 PKDKKV RO' Kai 62060 TuySn 3 CH107 3 PKDKKVYaXier 62131 Tuy€n 3 CH108 4 Trl;lmY t€ thi tr§.nSa ThAy 62101 Tuy€n 4 CH

12

, ~ I

sa TT Ma co I. Hangtheo Ten CO' s(rKCB UH'XT Tuyen coos(r Ghi chuTT s(rKCB CMKTmuc KCB

109 5 Tram Y t~xii SaNhon 62103 Tuyen 4 CH110 6 Tram Y t~xii MD Rai 62104 Tuyen 4 CH111 7 Tram Y t~xii Sa Scm 62105 Tuyen 4 CH112 8 Tram Y t~ xii Sa Nghia 62106 Tuyen 4 CH113 9 Tram Y t~xii Sa Binh 62107 Tuyen 4 CH114 10 Tram Y t~xiiYa Tang 62109 Tuyen 4 CH115 11 Tram Y t~xiiYa Ly 62110 Tuyen 4 CH116 12 Tram Y t~xiiHo Moong 62111 Tuyen 4 CH117 13 B~nh xi Binh doan 15 62132 Tuyen 3 CH

X Huyen Ia H'Drai118 1 TTYT Huyen Ia H'Drai 62140 Tuyen 3 4119 2 Tr!;lmY t~xii Ia Dal 62142 Tuyen 4 CH120 3 Tram Y t~xii Ia Dom 62143 Tuyen 4 CH121 4 Tram Y t~ xii Ia Toi 62144 Tuyen 4 CH* Ghi chll:

- Tuy~n tinh (goi hi tuyen 2), tuyen huyen (goi la tuyen 3), tuyen xii (goila tuyen 4).

- 8H: Chua phan hang.

13

I ~ ,

DANHSAcHKCBBHYTV

H<}pDONGHNAM2018

s6 Mil I. H~ng KCB KCBTen CO' sO' KCB BHYT cO'sO' Tuyen

b~nh nQi ngo~i Ghi chuTT KCB CMKT vien tru tru1 Benh vien Da khoa tinh 62001 Tuyen 2 2 x x

Phong kham Ban bao v~2 cham s6c SUC kh6e can 62010 Tuyen 2 2 0 x

bo tinh

Benh vien Phuc h6i clnrcN9i,

3 62058 Tuyen 2 3 x Ngoai trunang x chuyen

khoa

c6N9i,

B~nh vien y duQ'c62134 Tuyen 2 3 Ngoai tru4 , x x chuyentruyen

khoa

5Benh vien Da khoa khu

62127 Tuyen 3 3V\lC Ngoc H6i

x x

Trung Him Y te du phongTuyen 2

Ngoai tru6 tinh 62035 CH 0 x chuyen

khoa

Phong kham Trung tamTuyen 2

Ngoai tru7 Phong chong benh xa hQi 62036 CH 0 x chuyen

khoa

Trung tam Cham s6c sireTuyen 2

Ngoai tru8 62130 CH 0 x chuyen

khoe sinh san khoaTrung tam Y te huy~n

62002 Tuyen 3 39 Dak Glei x x

Trung tam Y te huy~n62003 Tuyen 3 3 010 Ngoc H6i x

Trung tam Y te huy~n62004 Tuyen 3 311 DakT6 x x

12Trung tam Y te huyen Sa

62005 Tuyen 3 3 x xTh~yTrung tam Y te huy~n

62006 Tuy~n 3 313 KonPlong x x

Trung tam Y te huy~n62007 Tuyen 3 314 DakHa

x x

14

sA : Mii· Tuy~o H\log KCB KCBTeo CO'SO' KCB BHYT cO'sq b~oh oQi ngoal Ghi chuTT . i KCB CMKT vi~o tru tru...

15Trung tam Y te huyen

62008 Tuyen 3 3 x xKon Rjiy

16Trung tam Y te thanh pho

62009 Tuyen 3 4 0 xKonTum

17Trung tam Y te huyen Tu

62013 Tuyen 3 3 x xMcyRong

18Trung tam Y te huyen Ia

62140 Tuyen 3 4 x xH'DraiTrung tam Y te dieu

19 duang Cong ty TNHH 62011 Tuyen 3 CH x xMTV Cao su Kon Tum

20 Benh xa BCH quan su 62124 Tuyen 3 CH x xtinh

21 Benh xa BCH Su doan 10 62126 Tuyen 3 CH x x(D24FI0)

22 Benh xa QDY khu V\lC 62132 TuySn 3 CH x xMo Rai - Binh doan 15

23 Benh xa Cong ty 732 - 62810 Tuyen 3 CH 0 xBinh dean 1524 Benh xa Con_gan tinh 62141 Tuyen 3 CH x x

Trung tam phong chong Tuyen 2Ngoai tru

25 mY/AIDS tinh 62145 CH 0 x chuyenkhoa

Ghi chu: D6i vai TTYT cdc huyen chi kY hop d6ng noi tru tai TTYThuyen(cac PKDK khu VlfC, TYT xa, thi trdn chi thuc hien KCB ngoai tru).

15