Medical Services Requested By Patient Not Covered By Insurance - Draft

So say the norms concerning the application of the frame-contract on healthcare through the social health insurance system for 2011-2012, to be approved through a joint order of the Minister of Health and the president of the National Health Insurance House.

Once the national social health insurance card system is implemented, healthcare providers will be obliged to ask patients for this document. Without such a card, the medical services will not be covered by social insurance, except those included in the minimal package (medical-surgical emergencies, illnesses with endemoepidemic potential, immunization, pregnancy tracking and postnatal).

To increase transparency, health insurance houses are required to publish the value of contracts with medical service suppliers and the suppliers' scores in every criteria used in setting the value.

Family doctors must add their patients' medical information into the national health insurance card system and keep this information up to date, once the cards are introduced.

Health insurance houses will cover the cost of up to two doctor visits if the diagnosis is known, when the patient is discharged from hospital or when under out-of-hospital treatment. They also cover two visits per case/diagnosis in the case of treatment via phytotherapy or homeopathy.

Services such as those provided by psychologists and speech therapists (the subject of contracts between health insurance houses and specialists) will be covered by social insurance according to an average daily ratio.

Doctor's notes are valid for 30 calendar days, except those issued for specific para-clinical investigations for illnesses handled by national healthcare programs, diabetes and nutrition illnesses, or cancer, which are valid for 90 calendar days, as long as medication has been prescribed for the same interval.

The note is valid for up to 60 days in the case of other chronic conditions. Within ten days of being written the doctor's note, the patient must schedule an appointment with a para-clinic service provider.

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