The National Health Insurance Service will link with the “treatment recipients’ eligibility check” to the qualifications of those eligible for the non-face-to-face medical treatment pilot project from September. (Courtesy of the Ministry of Health and Welfare)
The National Health Insurance Service will link with the “treatment recipients’ eligibility check” to the qualifications of those eligible for the non-face-to-face medical treatment pilot project from September. (Courtesy of the Ministry of Health and Welfare)

Starting this September, the eligibility check for the first-time patients of telemedicine pilot project will be linked to the National Health Insurance Service's “treatment recipients’ eligibility check.”

Through this procedure, the NHIS will pre-check patient eligibility before reimbursing non-face-to-face medical treatments.

According to sources in the medical community, the NHIS sent a letter to the Korean Medical Association and the Korean Pharmaceutical Association last Tuesday, telling them that the “information of the first-time patients of the non-face-to-face treatment pilot project will be provided through the treatment recipients’ eligibility check from Sept. 1.”

Under the new rule, neighborhood clinics must confirm the eligibility for remote care of second-time patients by referring to their medical records while confirming the eligibility of first-time patients through the treatment recipients’ eligibility check.

Accordingly, for the qualification inquiry for first-time patients, the NHIS plans to provide information on island and remote area residents, long-term care recipients aged 65 or more, and registered disabled people by including them in the treatment recipients’ eligibility check.

For the smooth implementation of the new rule, the NHIS will support the developers of related programs from Aug. 1 and apply the operating server from Sept. 1 when the trial period of the non-face-to-face medical treatment pilot project ends.

Inquiries for first- and second-time patients are related to hospitals and clinics and do not apply to pharmacies.

However, pharmacies must also confirm patients’ eligibility if they receive drugs at home for those island and remote areas residents, long-term care rating judges aged 65 or older, and registered disabled people.

The NHIS will check the eligibility for non-face-to-face care for all nursing institutions from Sept. 1 before reimbursing nursing care expenses.

Medical sources said that reflects the insurance authorities’ intention to strictly apply the new rule and discipline those who do not comply with it from Sept. 1 after the end of the transitional period after the introduction of the non-face-to-face medical treatment pilot project ends.

"We will actively manage the pilot project, Minister of Health and Welfare Cho Kyoo-hong said at the plenary session of the National Assembly’s Health and Welfare Committee on Friday. “We will check the system to prevent adverse effects from spreading by, for instance, slashing related insurance benefits and imposing disciplines for violators.”

 

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