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CHNG TRNH BO HIM

TAI NN & SC KHE


NM 2016 - 2017
CHNG TRNH DNH CHO
NHN VIN V NGI THN

T 01/04/2016 n 31/03/2017

GII THIU
S tay Bo him
Cho mng cc bn n vi Chng trnh bo him kt hp v Tai nn & Chm sc sc khe, Nm
vin v iu tr Ngoi tr ca Cng ty TNHH OFFICIENCE.
Nh cc bn bit, vi n lc khng ngng bo v v duy tr sc khe cho ton th nhn vin v
ngi thn, trong nm 2016 - 2017 Ban Lnh o ca Cng ty TNHH OFFICIENCE tip tc m rng
Chng trnh bo him Tai nn & Chm sc sc khe, Nm vin v iu tr Ngoi tr cho ton th
nhn vin v ngi thn.
Chng trnh ny c thc hin vi s phi hp ca Cng ty TNHH Aon Vit Nam v Cng ty Bo
Him PVI.
Chng ti hy vng Chng trnh bo him ny mang li nhng phc li thit thc cho cc bn, ng
thi gp phn hn ch nhng thit hi v ti chnh khi chng may bnh tt hoc ri ro xy n.
Cc bn hy tham kho tht k quyn s tay Chng trnh Bo Him ny v hy chm sc sc khe
tht tt.
Thn mn.

Trang 2 / 21

MC LC

GII THIU....................................................................................................................................................
1.

QUYN LI BO HIM AONCARE..................................................................................................

I.

Bo Him Tai Nn: ...............................................................................................................................

II.

Bo Him Sc Khe: ..........................................................................................................................

2.

QUY TRNH GII QUYT BI THNG.........................................................................................

3.

DANH SCH CC CHNG T CN THIT CHO VIC BI THNG...................................

4.

NHNG IM LOI TR CHNH....................................................................................................

5.

MT S LU QUAN TRNG I VI PHN BO HIM.....................................................

6.

A CH LIN H.................................................................................................................................

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1. QUYN LI BO HIM AONCARE


I.

Bo Him Tai Nn: n bo him ny bo him cho t vong/thng


tt vnh vin v chi ph y t iu tr tai nn gy ra bi cc nguyn nhn
tai nn xy ra trong vng 24 gi 1 ngy v hu qu ca tai nn xy ra
trong vng 52 tun k t ngy tai nn.
PHM VI LNH TH: Vit Nam

Quyn li Bo Him

C s bi thng

S tin bo him

A T vong/Thng tt vnh vin


- T vong/Thng tt
ton b vnh vin

100% s tin bo him

- Thng tt b phn
vnh vin

Bi thng phn trm theo


bng t l thng tt

VND 126,000,000

B Chi ph y t
(Bao gm Vn chuyn
cp cu bng mi
phng tin, nhng loi
tr vn chuyn bng
ng hng khng)

Bi thng chi ph y t thc t


(theo cc ho n chng t
hp l ca h s i bi
thng), mc bi thng ti
a nh hp ng bo him

Trang 4 / 21

Level 1: VND 105,000,000


Level 2: VND 63,000,000

II.

Bo Him Sc Khe: n bo him ny bo him cho chi ph y t, bi


thng t vong/ tn tt vnh vin, do bnh tt, m au, thai sn trong
thi hn bo him m khng b loi tr trong n.
PHM VI LNH TH: Vit Nam

A IU TR NI TR DO M AU,
BNH TT, THAI SN
Gii hn ti a/ nm/ ngi

Level 1

Level 2

VND 105,000,000

VND 63,000,000

Ti a VND
5,250,000/ngy

Ti a VND
3,150,000/ngy

(Ti a 60 ngy/nm)

(Ti a 60 ngy/nm)

Vin ph (chi ph v dch v v cung


cp v y t cn thit, pht sinh
trong thi gian nm vin, bao gm
nhng khng gii hn:
1

3
4
5
6
7
8
9

10

Chi ph ging, phng. Gii hn


phng n c gi thp nht ti
bnh vin.

Phng chm sc c bit ( 30


ngy/nm)

Cc chi ph y t hp l pht sinh


trong qu trnh nm vin.

Chi ph phu thut (chi ph pht


sinh lin quan n mt ca phu
thut ni tr, phu thut trong ngy
hoc phu thut ngoi tr) bao gm
nhng khng gii hn cho cc chi
ph sau:
Phng m
Gy m
Phu thut vin
Cy ghp ni tng ( ch
bao gm chi ph cy ghp)
- Ti m
iu tr cp cu (Ni tr, Ngoi Tr
v iu tr trong ngy)
Vn chuyn cp cu bng mi
phng tin (loi tr ng hng
khng)
Tr cp nm vin
(Ti a 60 ngy/nm)
Tr cp mai tng
iu tr trc khi nhp vin (trong
vng 30 ngy trc khi nhp vin)
iu tr sau khi xut vin (trong
vng 30 ngy k t ngy xut vin)
Y t chm sc ti nh (trong vng
30 ngy k t ngy xut vin)
Chi ph dng nhi (loi tr bnh
bm sinh v vacxin). Chi tr cc chi
ph iu tr bnh cp tnh pht sinh
trong vng 7 ngy sau sinh trong
thi gian nm vin cng m.

Chi tr ti hn mc ti a

Bi thng theo gii hn vin ph/ngy


Chi tr ti hn mc ti a
VND 105,000/ngy

VND 63,000/ngy

VND 2,100,000/nm

VND 2,100,000/nm

VND 4,200,000 /nm

VND 2,100,000 /nm

VND 4,200,000 /nm

VND 2,100,000 /nm

VND 3,150,000 /nm

VND 2,100,000 /nm

VND 630,000/nm

VND 420,000/nm

Trang 5 / 21

11

Thai sn

VND 35,000,000/nm

Thai sn v sinh con


- Sanh thng
- Bin chng thai sn v sinh kh

VND 25,000,000/nm

Bao gm trong cc gii hn t 1 - 10 trn

B IU TR NGOI TR DO M AU, BNH TT, THAI SN (BAO GM CHM SC RNG C


BN)
VND 8,400,000/nm

Gii hn ti a/ngi/nm
- Chi ph khm bnh
- Chi ph thuc men theo k toa ca bc s
- Chi ph chp X-quang, xt nghim, tr liu hc
bc x, cc liu php nh sng do bc s ch
nh v cn thit cho vic chn on v iu
tr bnh
- Chi ph khm thai nh k trc khi sanh
(3 ln/nm)

VND 1,800,000/ln khm


Khng gii hn s ln khm/nm

VND 700,000/nm

Chm sc rng c bn
- Khm v chn on bnh
- Chp X-quang
- iu tr vim nu (thi nu rng)
- Trm rng (amalgam hoc composite
hoc fuji hoc cht liu tng ng)
- iu tr ty rng
- Nh rng bnh l (km theo phu thut)
- Co vi rng (02 ln/nm, ti a VND
420,000/nm)
- Nha chu
(Ti H Ni v TP.HCM:
- Chi tr bi thng khm cha rng
ti cc bnh vin cng, cc phng
nha/ phng khm v cc phng nha
ca cc bnh vin thuc danh sch
bo lnh vin ph ca PVI
- Danh sch phng khm/ bnh vin
c th thay i theo thi gian v/
hoc chng trnh bo him
Tnh/ TP khc: Chi tr bi thng khm
cha rng ti tt c cc phng nha c
cp php hp php v c th xut ha
n GTGT theo quy nh ca B Ti
Chnh)

Trang 6 / 21

VND 1,800,000/nm

C T VONG/TN TT VNH VIN DO M AU, BNH TT, THAI SN


Quyn li bo him

C s bi thng

S tin bi thng
Level 1 & 2

T vong/ Tn tt vnh vin


T vong/Tn tt ton b
vnh vin

100% s tin bo him

VND 126,000,000/ ngi/ nm

Thi gian ch p dng cho nhn vin:

p dng cho nhn vin tham gia trn 12 thng : B qua tt c thi gian ch.

p dng cho tt c nhn vin mi v nhn vin tham gia hp ng c nhng cha
vt qua ht thi gian ch:

GII QUYT BI THNG THEO T L I VI QUYN LI THAI SN V SINH


TRONG KHONG THI GIAN CH SAU Y:
o

60 ngy k t ngy tham gia vo hp ng bo him i vi trng hp: sy thai, bin


chng thai sn cn thit phi no thai hoc iu tr theo ch nh ca bc s iu tr thai
sn

270 ngy k t ngy tham gia vo hp ng bo him i vi trng hp sinh

Ch 12 thng k t ngy tham gia cho nhng trng hp T vong/Tn tt vnh vin do cc
Bnh c bit v Bnh c sn, thai sn

Thi gian ch p dng cho ngi thn:

p dng cho Ngi thn tham gia trn 12 thng: B qua tt c thi gian ch.

p dng cho Ngi thn mi hoc ngi thn tham gia hp ng c nhng cha
vt qua ht thi gian ch:
-

Ch 30 ngy u tin k t ngy tham gia i vi iu tr v T vong/Tn tt vnh


vin do bnh thng thng

Ch 12 thng u tin k t ngy tham gia i vi iu tr bnh c bit

Ch 12 thng u tin k t ngy tham gia i vi iu tr bnh c sn

Ch 12 thng u tin k t ngy tham gia i vi T vong/Tn tt vnh vin do


cc Bnh c bit, Bnh c sn v Thai sn.

Ch 60 ngy k t ngy tham gia vo hp ng bo him i vi trng hp: sy


thai, bin chng thai sn cn thit phi no thai hoc iu tr theo ch nh ca bc
s iu tr thai sn

Ch 270 ngy k t ngy tham gia vo hp ng bo him i vi trng hp


sinh

Bnh c sn: L nhng bnh c t trc ngy bt u hiu lc bo him v l bnh m Ngi c
bo him:

iu tr trong vng 3 nm trc ngy bt u hiu lc bo him hoc

C triu chng v mt y khoa, tn ti v c ngun gc t trc khi bo him c hiu lc,


bt k l ngi c bo him c iu tr hay c t vn khm trc hay cha.
Trang 7 / 21

Ngoi cc bnh c sn theo nh ngha trn, mt s bnh sau c hiu l bnh c sn: vim Amidan
cn phi ct, vim VA cn phi no, vo vch ngn cn phu thut, ri lon tin nh, thoi ha khp/
t sng, vim tai gia cn phu thut, thoi v a m, bnh hen.
Bnh c bit: L cc bnh ung th v u cc loi, huyt p, tim mch, lot d dy, vim a khp mn
tnh, lot rut, vim gan cc loi, vim mng trong d con, tr, si, cc loi trong h thng tit niu v
ng mt, c thy tinh th, vim xoang, bnh i tho ng, Parkinson, bnh lin quan n h
thng to mu.

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2. QUY TRNH GII QUYT BI THNG


2.1.

QUY TRNH YU CU BO LNH VIN PH


Ngi c bo him

Bnh vin/ Phng


khm

Xut trnh th Aon


Care/CMND/ Th
nhn vin hoc
giy khai sinh (tr
em)

PVI

Thng
bo

Cung cp
thng tin

ng

K xc nhn giy
bi thng

T chi
Tr tin mt

Ch thch:

2.2.

Cc bc tin hnh

iu kin

QUY TRNH TR TRC BI THNG SAU

* Ngy c hiu l ngy lm vic.


Gi h s trong vng 360 ngy k t ngy bt u
chm dt vic iu tr, ra vin hoc t vong (Ngi
c bo him)

02 ngy lm vic
Thng bo nhn c h s
(PVI)
H s chng t
5 ngy
lm vic

10 ngy lm vic
Gi thng bo bi thng

H s thiu chng t
01 ngy

Tr tin mt

Trang 9 / 21

5-7 ngy

Chuyn Khon

LU :
Thi gian gii quyt h s l 10 ngy lm vic.
Nu s tin bi thng khc s tin yu cu bi thng, PVI cn s xc nhn ng ca
NBH trong vng 3 ngy lm vic. Trng hp khng nhn c xc nhn ng chuyn
khon s tin bi thng ca NBH, PVI s t ng chuyn tin sau 5-7 ngy k t ngy
thng bo bi thng.
H s gi n cho cng ty bo him c hiu l khch hng khng ly li v cng ty bo
him khng c trch nhim hon tr; tr trng hp i vi nhng chng t khng thuc
phm vi bo him, ngi yu cu bi thng c th yu cu tr li trong vng 1 thng sau khi
nhn c thng bo khng bi thng.
Sau khi iu tr xong, ngi c bo him nn gi h s ngay cho phng nhn s/ Aon hoc
thng bo cho phng nhn s/ Aon qua email/ vn bn v ri ro xy ra khi vic iu tr cha
hon tt. Vic np h s phi c thc hin trong vng 360 ngy k t ngy chm dt vic
iu tr, ra vin hoc t vong ca Ngi c bo him.
Thc mc v tnh trng h s c th hi trc tip Aon/PVI.
Kim tra v quyn li bo him, th tc bi thng, cch gii quyt bi thng lin h Aon.

3. DANH SCH CC CHNG T CN THIT CHO VIC BI


THNG
3.1.
BO HIM TAI NN CON NGI:
1. Giy yu cu bi thng (theo mu do nh bo him cung cp) c in y thng tin v
c ch k ca ngi c bo him (tr phi ngi c bo him khng c kh nng k)
2. Hp ng lao ng (nu cha c khai bo tn trong danh sch)
3. Trng hp t vong: Giy chng t, v cc chng t xc nhn quyn tha k hp php bao
gm:
Xc nhn nhn thn (xc nh hng tha k) ca NBH ti UBND phng ni c tr
M t khai di sn tha k ti phng cng chng
y quyn ca nhng ngi ng tha k c xc nhn ca phng cng chng
Bn sao CMND ca nhng ngi tha k, giy khai sinh (con), h khu
Bn sao giy chng t
Giy ly hn/ kt hn (bn sao)
4. Trng hp thng tt vnh vin v thng tt tm thi:
Cc chng t y t cn cung cp:
Chng nhn bnh l (nu c)
n thuc hoc s khm bnh (c ng du ca c s khm cha bnh v ch k ca
bc s)
Giy ra vin v bng k vin ph trong trng hp iu tr ni tr
Phiu m hoc Giy chng nhn phu thut trong trng hp c phu thut
Cc chng t y t khc nh ch nh v kt qu cc xt nghim, kim tra,
Ho n, bin lai, phiu thu c ghi chi tit tng khon mc c thanh ton hoc c bng
k nh km
Bn gim nh thng tt ca Hi ng gim nh y khoa
5. Bn tng trnh tai nn:
a. Tai nn sinh hot
S tin bi thng di 3 triu, ch cn bn tng trnh tai nn, khng cn xc nhn, ch
cn tng trnh chi tit trn claim form
S tin trn 3 triu, cn bn tng trnh tai nn theo mu PVI c xc nhn ca cng ty
Trng hp c bit, cn c vo h s bnh n
b. Tai nn giao thng:
S tin di 3 triu: Tng t tai nn sinh hot
S tin trn 3 triu: cn cung cp bin bn tai nn giao thng, hoc bn tng trnh theo
mu PVI c xc nhn ca cng ty
Trang 10 / 21

Trng hp tai nn nghim trng, cn cung cp bin bn tai nn giao thng (nu c cng
an th l h s) hoc bn tng trnh tai nn c xc nhn ca cng an a phng
Trng hp iu khin xe my cn photo giy ng k xe v bng li xe (nu iu khin xe
trn 50cc)

c. Tai nn lao ng:


Trong mi trng hp, Bin bn tai nn do c quan ch qun lp v xc nhn.
Nu ngi c bo him b cht: Bin bn tai nn lao ng do c quan ch qun lp c
cc c quan, cc ban nghnh lin quan nh Cng an, Vin kim st... cng xc nhn
3.2.
BO HIM SC KHO:
Giy yu cu bi thng (Mu giy ny do nh bo him cung cp)
Chng nhn bnh l (nu c)
n thuc hoc s khm bnh (c ng du ca c s khm cha bnh).
Giy ra vin v bng k vin ph trong trng hp iu tr ni tr
Phiu m hoc Giy chng nhn phu thut trong trng hp c phu thut
Cc chng t y t khc nh ch nh v kt qu i km cho cc xt nghim, siu m, Xquang, MRI,
7.
Ho n, bin lai, phiu thu c nh km chi tit tng khon mc c thanh ton hoc c
bng k nh km
8.
iu tr rng: cn cung cp Phiu iu tr rng hoc S iu tr rng th hin cc thng
tin sau:

V tr rng

Nguyn nhn cn iu tr (nh rng phi ghi r nguyn nhn v c phim XQ)

Cch iu tr

Trm rng: ghi r bng cht liu g

iu tr ty rng: cn cung cp film chp hoc kt qu chp ty v qu trnh iu tr ty


rng

Ngy iu tr

K tn v ghi r h tn ca bc s iu tr

ng du ca bnh vin hoc nha khoa


1.
2.
3.
4.
5.
6.

Lu :
1. Chng t iu tr:
Phi th hin triu chng bnh lc n khm, phi c chn on bnh cui cng trn toa
thuc/bo co bnh n/s khm bnh.
n thuc phi ng theo mu ca B Y t, c ch k, h tn y ca bc s iu tr v
ng du xc nhn ca ni khm cha bnh. n thuc ch c gi tr mua thuc trong
vng 5 ngy k t ngy k n. Mi chnh sa trn n thuc u phi c ch k xc nhn
ca bc s.
Nu ti khm trc khi dng ht thuc hoc trc ngy ch nh ti khm ca bc s phi
c nguyn nhn th hin trong h s.
Xng mi, ra xoang, kh dung, tp vt l tr liu phi c ch nh c th ca bc s iu tr.
2. Chng t thanh ton:
Chng t thanh ton phi hp l vi y chi tit ni dung thanh ton (H tn, a ch,
ch k ca ngi mua hng, ch k ca ngi bn hng, tn hng ha dch v, n v
tnh, s lng, n gi, thu sut, tng s tin thanh ton,) v l bn chnh.
Ha n ghi tn ngi khm bnh. Cc chi ph pht sinh t cng mt c s iu tr nh
tin khm, tin xt nghim, chn on hnh nh, tin thuc,trn 200,000 VND phi c
ha n ti chnh. Vic tch ra thnh nhiu ha n bn l s khng c chp nhn.
Ha n ti chnh c xut qu 30 ngy k t ngy pht sinh dch v s khng c
chp nhn trong bt c trng hp no.
Ha n/ bin lai thu tin vin ph bt buc phi c ng du hp l ca ni khm cha
bnh. Chi ph tin khm, xt nghim, tin thuc phi c bng k chi tit i km.
3. Lu chung:
Trang 11 / 21

Nu iu tr ngoi tr ti bc s t, bc s t phi c giy php hnh ngh v giy php m


c s khm cha bnh. Toa thuc, ha n phi th hin s giy php hnh ngh v a
ch vn phng lm vic ca bc s. (Lu : Bc s t ch c php khm cha bnh
khng c bn thuc).
Ni soi cc bnh vin c giy ra vin: c gii quyt theo quyn li ngoi tr (v thc
cht khng mang tnh cht iu tr bnh, khng pht sinh tin ging, khng l thng l
trn th trng).
Hp ng bo him ch bi thng chi ph mua thuc c k toa. Vitamin khng vt qu
lng thuc iu tr trong cng 1 toa thuc v h tr iu tr bnh vn c chi tr. Thuc
b, m phm, thc phm chc nng, vt t y t, khng c bo him.
Ch c bnh vin mi c chc nng iu tr ni tr, phng khm th khng c chc nng
ny.
Khng phi tt c nhng xt nghim theo ch nh ca bc s u thuc phm vi bo him.
Ch nhng xt nghim cn thit, hp l lin quan trc tip n triu chng bnh v chn
on bnh cui cng mi c xem xt bi thng.

4. NHNG IM LOI TR CHNH


(Chi tit y , vui lng xem trong Quy tc bo him)
4.1.

4.2.

4.3.

LOI TR CHUNG
iu tr ngoi phm vi a l quy nh trong hp ng
iu tr v/ hoc chm sc cai nghin ma ty, cai nghin ru, s dng thuc khng
theo ch nh ca C s y t/bc s.
Bt k m au, bnh tt, thng tch hay cht no gy ra bi chin tranh, ni chin,
nh cng, khng b, ng t ni la, dch bnh, nhim ha hc, cht phng x
Hnh ng c ca Ngi c bo him hoc ngi tha k hp php.
Ngi c bo him c nh t t hoc c dn thn vo ni nguy him khng cn
thit tr khi c nh cu ngi, cu ti sn. Thng tt pht sinh t vic nh ln tr
phi bo v tnh mng c nhn.
Ngi c bo him t 14 tui tr ln vi phm nghim trng php lut, ni quy, quy
nh ca chnh quyn a phng hoc cc t chc x hi, vi phm nghim trng lut l
an ton giao thng. (Mc nghim trng s ph thuc vo nh gi ca BO HIM
PVI).
Ngi c bo him b nh hng ca ru, bia, ma tu hoc cc cht kch thch
tng t khc.
Bt k vic iu tr hoc th nghim no lin quan n cc bnh ly lan qua ng tnh
dc (lu, giang mai), bt k hi chng phc hp lin quan n hi chng suy gim
min dch mc phi (AIDS), tnh trng v bnh lin quan n virut HIV.
iu tr tt c cc loi bnh tm thn hoc ri lon tm thn.
T vong hoc bt k m au, bnh tt, thng tch no pht sinh trc tip hoc gin
tip t nhim ha hc, cht phng x hay nguyn liu ht nhn hay thin tai nh:
ng t, ni la hoc dch bnh gy ra.
Chi ph iu tr phc hi chc nng, vt l tr liu (tr trng hp iu tr ngoi tr),
cung cp, duy tr hay chnh sa cc b phn hoc dng c gi c lp t t bn
ngoi bao gm dng c y t iu tr, cc b phn gi, rng gi hoc cc thit b iu
chnh, nng chng, xe y
LOI TR I VI PHN BO HIM TAI NN
Tham gia tp luyn hoc tham gia thi u cc mn th thao chuyn nghip, bt k hot
ng ua no.
LOI TR I VI PHN BO HIM SC KHE
Cc sn phm vitamin hoc khong cht, thc phm chc nng, cc loi thuc b sung
cho ch dinh dng, n king bao gm c cc sn phm lm p (tr trng hp
c s dng iu tr theo chn on, triu chng thiu ht vitamin in hnh).
iu tr cc chng bnh lin quan n vic tr ngi v ng h hp, bao gm ng
ngy v ngng th khi ng.
Bt k hnh thc iu tr hoc thuc th nghim no hoc cha c chng minh da
trn thc tin y hc c chp nhn rng ri.
Trang 12 / 21

iu dng, an dng.
Kim tra sc kho hoc khm gim nh y khoa m khng lin quan n vic iu tr
bnh tt.
Khm sc kho nh k /thng l, bao gm kim tra sc kho tng qut, khm ph
khoa, nam khoa, xt nghim, khm thai nh k, chm sc tr s sinh, tim chng, ung
vc xin phng nga, kim tra th lc v thnh lc thng thng, iu tr suy thoi th
lc/t nhin, bao gm nhng khng gii hn iu tr cn th, vin th, lon th v nhng
phu thut sa cha nhng khim khuyt v suy thoi th lc v thnh lc t nhin.
iu tr hoc phu thut cc bnh, d tt bm sinh, di truyn, nhng thng tt v ch
nh phu thut c t trc ngy bt u bo him.
iu tr hoc phu thut theo yu cu ca Ngi c bo him.
Gii phu thm m hoc phu thut to hnh tr khi vic gii phu ny nhm mc ch
ti to phc hi chc nng ca c quan b tn thng pht sinh trong thi hn bo
him.
K hoch ho gia nh, iu tr v sinh, iu tr bt lc, ri lon chc nng sinh dc, th
tinh nhn to, liu php thay i hc mn, thay i gii tnh hay bt c hu qu hoc
bin chng no ca iu tr trn. No ph thai tr trng hp c ch nh cn thit v
mt y khoa phi chm dt thai k.
Cc bnh lao, bnh phong, st rt

5. MT S LU QUAN TRNG I VI PHN BO HIM


5.1.

IU KIN THAM GIA BO HIM:


T 15 ngy tui n 65 tui
Khng mc bnh tm thn, phong, ung th
Khng b thng tt vnh vin t 50% tr ln
Lu :

Ngi thn bao gm cha m rut, cha m v, cha m chng, v


chng v con ci c php lut tha nhn.

Con ci l nhng ngi t 15 ngy tui n 18 tui hoc n 24 tui


ang theo hc cc kha di hn ton thi gian, cha kt hn v sng ph thuc
vo ngi c bo him.

Quyn li thai sn s khng p dng cho con ci


5.2.
NH NGHA MT LN KHM:
Mt ln khm bnh l mt ln ngi bnh c thy thuc thm
khm lm sng c hoc khng kt hp vi cn lm sng (xt nghim, chn on hnh
nh, thm d chc nng) hay cc th thut thm d khc nhm mc ch chn on
bnh v iu tr.
Trng hp sau khi khm mt chuyn khoa, nu cn phi gi ngi
bnh i khm chuyn khoa khc, th mi ln khm mt chuyn khoa c tnh l mt ln
khm bnh.
Trng hp nhiu thy thuc chuyn khoa cng hi chn trc mt
ngi bnh theo quy ch bnh vin th ch c tnh l mt ln khm bnh.
Trng hp ngi bnh khm mt chuyn khoa nhiu ln trong
ngy th ch c tnh l mt ln khm bnh. Trng hp ngi bnh khm nhiu
chuyn khoa trong cng Mt c s y t, trong mt ln khm bnh nu c chn on
bnh v ch nh iu tr ca bc s mi khoa th tng ng vi mi khoa c tnh l 1
ln khm bnh.
5.3.
BO LNH VIN PH THEO QUY NH CA PVI:
5.1.1. Bo lnh vin ph khng p dng cho:
iu tr tai nn hay hu qu ca tai nn trc
iu tr cp cu
Gi thai sn khng c chi tit km theo
Trang 13 / 21

Cc chi ph khm, xt nghim ... trc khi nhp vin, chi ph ti khm sau xut
vin, chi ph dng nhi, v cc khon tr cp
Khng p dng bo lnh vin ph cho Ngoi tr ( bao gm iu tr rng)

5.1.2. Nu gp tr ngi khi yu cu Bo lnh vin ph ti cc C s y t nm trong danh


sch lin kt vi PVI: vui lng lin h s in thoi h tr Bo lnh vin ph in trn
mt sau ca th bo him PVI Care c h tr nhanh nht.
5.4.
NG BO HIM:
- p dng ng bo him 30-70 ti cc bnh vin, phng khm quc t sau:
Bnh vin Php Vit
Bnh vin a khoa quc t V Anh
Bnh vin quc t ph sn Si Gn
Bnh vin Hnh Phc
Bnh vin, phng khm Columbia
Bnh vin quc t Vinmec
Bnh vin Hng Ngc
Phng khm Victoria M M
- Trng hp tn tht vt qu 70%, t l ng bo him trn s thay i thnh 50-50

Trang 14 / 21

PH LC THAM KHO
DANH SCH BO LNH VIN PH NI TR
STT

BNH VIN/PHNG KHM

A CH

IN THOI

Bnh vin Hu Ngh

S 1 Trn Khnh D, Hai B Trng, H Ni

04 38221937

Bnh vin Y Hc C Truyn


Trung ng
Bnh vin a khoa Quc t
Vinmec

29 Nguyn Bnh Khim, qun Hai B Trng,


H Ni
458 Minh Khai, Phng Vnh Tuy, qun Hai
B Trng

Bnh vin a Khoa Tr c

219 L Dun, qun Hai B Trng

04 3942 9999

Bnh vin Ph Sn An Thnh

496 Ph Bch Mai, Hai B Trng, H Ni

04 6250 4445

Bnh vin mt Vit Nht

122 Triu Vit Vng, Bi Th Xun, Hai B


Trng, Vit Nam

04 3974 8307

Bnh vin i hc Y H Ni

S 1 Tn Tht Tng, qun ng a

04 3574 7788

S 78 ng Gii Phng, qun ng a

04 3576 5990

Ng 1194 ng Lng, qun ng a

04 37664751

18/879 ng La Thnh, qun ng a

04 6273 1090

H NI
1
2
3

8
9
10
11

Bnh vin Bnh Nhit i


Trung ng
Bnh vin Giao thng vn ti
Trung ng
Khoa T nguyn A - Bnh
Vin Nhi Trung ng
Bnh vin ni tit Trung
ng c s 2

Khu B, Yn Lng, Thi Thnh, ng a, H


Ni
S 5 o Duy Anh, Phng Phng Lin,
ng a, H Ni

04 38263616
04 3975 1206

04 3853 3527

12

Bnh vin ng

13

Bnh vin Vit Php

S 1 Phng Mai, Qun ng a

04 3577 1100

14

Bnh vin a khoa Bo Sn


2

52 Nguyn Ch Thanh, ng a, H Ni

04 3775 7099

15

Bnh vin a khoa Xanh-pn

12 Chu Vn An. in Bin, Ba nh, H Ni

04 382233075

16

Bnh vin a khoa Hng


Ngc c s 1

55 Yn Ninh, qun Ba nh

04 7305.8880

17

Bnh Vin Bu in

S 49 Trn in, qun Hong Mai

04 3640 2262

S 8 Ph Don, qun Hon Kim

04 3828 9402

40 Trng Thi, qun Hon Kim

04 3828 5347

Ng 215, ng Ngc Hi, Th trn Vn


in, Thanh Tr, H Ni

04 6288 5152

286 Thy Khu, Ty H H Ni

04 3835 5555

18
19
20
21
22
23

24

25

Khoa iu tr theo yu cu
1C- Bnh vin HN Vit c
Bnh vin Rng Hm Mt
Trung ng H Ni
Bnh vin ni tit Trung
ng
Bnh vin a khoa Quc t
Thu Cc
Bnh vin a khoa Hng
Ngc c s 3
Bnh vin a khoa Hng
Ngc c s 2
HI PHNG
Bnh vin i hc Y Hi
Phng
THI NGUYN
Bnh vin a khoa Trung
ng Thi Nguyn

Tng 3, Ta B, Savico Megamall, 07-09


Nguyn Vn Linh, Long Bin, H Ni
Khu B1, tng 10, Keangnam Landmark 72,
Phm Hng, H Ni

04 6278 4449

04 39 275 568
04 3927 5568

S 225C Lch Tray- qun Ng Quyn- Hi


Phng

031 373 6285

479, Lng Ngc Quyn, TP.Thi Nguyn,


Tnh Thi Nguyn

0280 385 5514

Trang 15 / 21

THANH HA
26

27

28
29

Bnh vin a khoa Hp Lc


HU
TT iu tr theo yu cu v
quc t - BV TW Hu
NNG
Bnh vin K Fortis Hon M
Nng
Bnh vin Tm Tr Nng

595 Nguyn Ch Thanh, ng Th, TP.


Thanh Ha

0373 713 713

S 3 Ng Quyn, Phng Vnh Ninh, Tp.


Hu

0543890888

161 Nguyn Vn Linh, qun Thanh Kh, TP


Nng
64 Cch Mng Thng Tm, P.Khu Trung,
Q.Cm L, TP. Nng

0511 3650 676


0511 2476 479

QUNG NAM
30

Bnh vin a khoa Trung


ng Qung Nam

Thn Nam Sn, X Tam Hip, huyn Ni


Thnh, tnh Qung Nam

0510 2476 479

34/4 Nguyn Thin Thut, Phng Tn Lp,


Nha Trang, tnh Khnh Ha

058 3528 866

KHNH HA
31

Bnh vin 22-12


H CH MINH

32

Bnh vin T D - Ni tr

284 Cng Qunh, P. Phm Ng Lo, Qun 1

08 3839 5117

33

Bnh vin Nhi ng 2

33 Nguyn Du, Qun 1

08 3829 8385

263-265 Trn Hng o, P. CG, Qun 1

08 3836 0191

1-3 Trnh Vn Cn, P. Cu ng Lnh, qun 1

08 3821 3456

34
35

Bnh vin Rng Hm Mt TP


HCM
Bnh vin Tai Mi Hng Si
Gn

36

Bnh vin Y Hc C Truyn

179 Nam K Khi Ngha, Qun 3

08 3932 6004

37

Bnh vin Bnh Dn

371 in Bin Ph, P.4, Qun 3

08 3839 4747

38

Bnh vin Tai Mi Hng TP


HCM

155B Trn Quc Tho, P.9, Qun 3

08 3931 7381

39

Bnh vin Mt TP HCM

280 in Bin Ph, P.7, Qun 3

08 3932 6732

215 Hng Bng, Qun 5

08 3855 4269

201 Nguyn Ch Thanh, Phng 12, Qun 5

08 38570757

221B Hong Vn Th, Qun Ph Nhun

08 3844 2756

S 10 Trn Huy Liu, qun Ph Nhun

08 3845 7777

40
41
42
43

Bnh vin i hc Y Dc
TP HCM
Bnh vin i Hc Y Dc TP HCM c s 2
Bnh vin i Hc Y Dc TP HCM c s 3
Bnh vin a khoa T nhn
An Sinh

44

Bn vin a Khoa Hon M

60 - 60A Phan Xch Long, F1, qun Ph


Nhun

08 3990.2468

45

Bnh vin Quc T Columbia


Asia Gia nh

S 01 N Trang Long, qun Bnh Thnh

08 3823 8888

46

Bnh vin Ph Sn M Kng

47

Bnh vin Triu An

48

Bnh vin a Khoa Vn


Hnh

700 S Vn Hnh, Phng 12, Qun 10

08 3863 1272

49

Bnh vin Php Vit

6 Nguyn Lng Bng, Nam Si Gn, Qun 7

08 5411 3333

243-243A-243B Hong Vn Th, Qun Tn


Bnh
425 Kinh Dng Vng, Phng An Lc,
qun Tn Bnh

Trang 16 / 21

08 3844 2986
08 3750 8888

50

Bnh Vin a Khoa Hng


c

32/2 Thng Nht, Phng 10, Qun G Vp

08 3996 9999

51

Bnh vin Quc nh

104 - 110 ng 54, KT Tn To, qun


Bnh Tn

08 5407 3878

1048A Phm Vn Thun. Phng Tn Mai,


TP. Bin Ha, Tnh ng Nai

0613 955 955

13 Phm Ngc Thch, Phng Phc Hng,


Tp. B Ra

064 374 2318

NG NAI
52

Bnh vin Quc t ng Nai


B RA-VNG TU

54

55
56

57
58

Bnh vin B Ra
CN TH
Bnh vin a khoa Hon M
Cu Long
Bnh vin Quc t Phng
Chu
C MAU
Bnh vin a khoa tnh C
Mau
Bnh vin a khoa Hon M
Minh Hi
MALAYSIA

59

Subang Jaya Medical Centre

60

Ara Damansara Medical


Centre

61

Parkcity Medical Centre

L 20 Quang Trung, Ph Th, Ci Rng, TP.


Cn Th
300 Nguyn Vn Linh, An Khnh, Ninh Kiu,
Cn Th

0710 391 7901


0710 2222 555

S 16 Hi Thng Lng ng, F4, TP C Mau

0780 3835 171

09 Lc Long Qun - u C, khm 5, Phng


7, TP C Mau

0780 357 5859

No.1, Jalan SS 12/1A, 47500 Subang Jaya,


Selangor Darul Ehsan, Malaysia
Lot 2, Jalan Lapangan Terbang Subang,
Seksyen U2, 40150 Shah Alam, Selangor
Darul Ehsan, Malaysia
No.2, Jalan Intisara Perdana, Desa Parkcity,
52200, Kuala Lumpur, Malaysia

Ghi ch:
- Danh sch bnh vin/phng khm c th thay i theo thi gian/chng trnh bo him.
- Qu khch vui lng xut trnh th PVI Care v CMTND/Giy khai sinh c chp nhn bo lnh.
Trong trng hp nm vin ni tr, vui lng xut trnh giy t trong vng 24h sau khi nhp vin.
- Lu ring:
+ Bo lnh ti Bnh vin Nhi TW, Rng Hm Mt TW H Ni cn chun b bn sao th, CMTND/Giy
khai sinh.
+ Khm cha Rng ti BV Rng hm mt TP HCM, BV Rng hm mt Trung ng : cn t hn vi Bo
him PVI trc 1 ngy.

PH LC THAM KHO
NI IU TR NHA KHOA C CHP NHN GII QUYT BI THNG
STT

1
2
3
4

BNH VIN/PHNG KHM


H NI
Qun Hai B Trng
Bnh vin Hu Ngh
Bnh vin a khoa Quc t Vinmec
Bnh vin a Khoa Tr c
Phng khm Nha khoa c Chu
Qun ng a

A CH

S 1 Trn Khnh D, Hai B Trng, H Ni


458 Minh Khai, Phng Vnh Tuy, qun Hai B Trng
219 L Dun, qun Hai B Trng
S 3, Nguyn Du, P. Bi Th Xun, Q. Hai B Trng

Trang 17 / 21

5
6
7
8

Bnh vin i hc Y H Ni
Bnh vin Bnh Nhit i Trung
ng
Bnh vin Giao thng vn ti Trung
ng
Khoa T nguyn A - Bnh Vin Nhi
Trung ng

Bnh vin ng

10
11
12
13

Bnh vin Vit Php


Bnh vin a khoa Bo Sn 2
Phng khm 125 Thi Thnh
Nha khoa DR BEAM
Qun Ba nh
Bnh vin a khoa Xanh-pn
Bnh vin a khoa Hng Ngc c s
1
Qun Hong Mai
Bnh Vin Bu in
Qun Hon Kim
Bnh vin Rng Hm Mt Trung
ng H Ni
Phng khm Medelab
Phng khm a kha quc t
Vietsing
Phng khm Nha khoa Nguyn Du
Huyn Thanh Tr

14
15
16
17
18
19
20
21
22
23

24
25

Bnh vin ni tit Trung ng


Qun Ty H
Bnh vin a khoa Quc t Thu Cc
Huyn T Lim
Bnh vin a khoa Hng Ngc c s
2
Qun Long Bin
Bnh vin a khoa Hng Ngc c s
3
Qun Cu Giy
Nha khoa quc t Vit Php

S 1 Tn Tht Tng, qun ng a


S 78 ng Gii Phng, qun ng a
Ng 1194 ng Lng, qun ng a
18/879 ng La Thnh, qun ng a
S 5 o Duy Anh, Phng Phng Lin, ng a, H
Ni
S 1 Phng Mai, Qun ng a
52 Nguyn Ch Thanh, ng a, H Ni
125 Thi Thnh, Thnh Quang, ng a, H Ni
S 124, x n, ng a, H Ni
12 Chu Vn An. in Bin, Ba nh, H Ni
55 Yn Ninh, qun Ba nh
S 49 Trn in, qun Hong Mai
40 Trng Thi, qun Hon Kim
1B Yt Kiu, Hon Kim, H Ni
Ta nh Pacific 83b L Thng Kit, Hon Kim, H Ni
S 2-4 Nguyn Du, Hng Bi, Qun Hon Kim
Ng 215, ng Ngc Hi, Th trn Vn in, Thanh Tr,
H Ni
286 Thy Khu, Ty H H Ni
Khu B1, tng 10, Keangnam Landmark 72, Phm Hng,
H Ni
Tng 3, Ta B, Savico Megamall, 07-09 Nguyn Vn
Linh, Long Bin, H Ni
S 24 Trn Duy Hng, Cu Giy, H Ni

H CH MINH
Qun 5
1
2
3
4
5
6
7
8

Bnh vin i hc Y Dc TP HCM


Nha khoa 2000
Qun 1
Bnh vin Nhi ng 2
Bnh vin Rng Hm Mt TP HCM
Bnh vin Quc T Columbia Asia
Phng khm Vit Gia
Nha khoa Minh Khai
Phng khm a khoa Quc t Si
Gn

215 Hng Bng, Qun 5


C s 2: 502 Ng Gia T, Phng 9, Qun 5
33 Nguyn Du, Qun 1
263-265 Trn Hng o, P. CG, Qun 1
08 ng Alexandre De Rhodes - Qun 1
166 Nguyn Vn Th, Phng a Kao, Q1, TP HCM
199 Nguyn Th Minh Khai, Qun 1
9-15 Trnh Vn Cn, P. Cu ng Lnh, Qun 1, TP.HCM
Trang 18 / 21

9
10
11
12

Nha khoa k thut s


Nha khoa 2000
Qun Ph Nhun
Bnh vin a khoa T nhn An Sinh
BnH vin a Khoa Hon M

15

Qun 10
Bnh vin a Khoa Vn Hnh
Nha khoa No.1
Qun 7
Bnh vin Php Vit

16

Nha khoa Vit M

17

Nha khoa Sakura

18
19

Qun Tn Bnh
Bnh vin Triu An
Nha khoa Sky

13
14

S 10 Trn Huy Liu, qun Ph Nhun


60 - 60A Phan Xch Long, F1, qun Ph Nhun
700 S Vn Hnh, Phng 12, Qun 10
51 ng 3/2, F11, Qun 10
6 Nguyn Lng Bng, Nam Si Gn, - Qun 7
1288 Hunh Tn Pht, Phng Ph M, Qun 7,
TP.HCM
69(R4-14) L Vn Thim, Hng Phc 3, P. Tn Phong,
Qun 7, HCM
425 Kinh Dng Vng, Phng An Lc, qun Tn Bnh
Lu 2, 444 Hong Vn Th, P.4, Q.Tn Bnh, Tp.HCM

21

Qun G Vp
Bnh Vin a Khoa Hng c
Qun Bnh Tn
Bnh vin Quc nh

22
23
24
25

Qun 3
Phng khm a khoa Song An
Nha khoa Vit Giao
Nha khoa Elite
Phng Khm a Khoa An Khang

20

62 ng Dung, Phng Tn nh, Qun 1


C s 1: A36B Cng Qunh, P.Nguyn C Trinh, Qun 1

32/2 Thng Nht, Phng 10, Qun G Vp


104 - 110 ng 54, KT Tn To, qun Bnh Tn
510 Nguyn nh Chiu, Phng 4, Qun 3
71 Phm Ngc Thch, F6, Qun 3
57A Trn Quc Tho F7 Q3 TPHCM
184-186-188 Nguyn nh Chiu, Phng 6, qun 3

Huyn C Chi
26

Phng khm Thin Y

703 Quc l 22, KP 5, Th trn C Chi, Huyn C Chi,


HCM
Tnh/ TP khc

Chi tr bi thng khm cha rng ti tt c cc phng nha c cp php hp php v c th


xut ha n GTGT theo quy nh ca B Ti Chnh)

PH LC THAM KHO
STT

Nha khoa

DANH SCH CC NHA KHOA T CHI THANH TON


a ch

Bnh Dng
1

Nha khoa Vn Thnh

Huyn Tn Uyn, Bnh Dng

Nha Khoa Tng lai Nht

Huyn Tn Uyn, Bnh Dng


584 CMT8, Phng Ph Cng, TX Th Du Mt, Tnh Bnh Dng

Nha Khoa i Nam

180 Yersin, TX Th Du Mt,Tnh Bnh Dng


033/A Th trn Uyn Hng (i din ch), Huyn Tn Uyn, Tnh
Bnh Dng
033/A Th trn Uyn Hng (i din ch), Huyn Tn Uyn, Tnh
Bnh Dng

ng Nai
4
5

Nha Khoa Bn Thnh


Nha Khoa Nam Si Gn

22 Khu ph 3 Nguyn i Quc, TP.Bin Ha


141/7 Phm Vn Thun, TP. Bin Ha
Trang 19 / 21

P. Tn Mai, TP. Bin Ha


6

Nha Khoa Vit Hoa

30/4 P. Trung Dng, TP. Bin Ha

Nha Khoa Thanh Lim

Nha Khoa Kim Phng

Nha Khoa Sinh Hu

Bin Ha, ng Nai


526 L Dun, Khu Phc Thun, TT.Long Thnh, H.Long Thnh,
ng Nai
S 27A/13, KP 5, P. Trng Di, TP. Bin Ho, ng Nai

10

Nha Khoa Ngc Pht

1 Nguyn i Quc, Tn Phong, Bin Ha, ng Nai

11

Nha Khoa Hong Gia

217A/1, KP2, Phm Vn Thun, Tn Tin, Bin Ha - ng Nai

12

Nha Khoa Phc Trch

p 3, X Hip Phc, Huyn Nhn Trch, Tnh ng Nai

13

Nha Khoa Ton Nha

KP2, P.Trung Dng, Bin Ha, ng Nai

14

Nha Khoa Vit Anh c

3/10-3/11, ng Khi, Tam Hip, Bin Ha, ng Nai

Tin Giang
15

Nha Khoa Cng ngh Mi 3D

43/12 inh B Lnh, M Tho, Tin Giang

Khnh Ha
43A L Thnh Phng, P.Vn Thng, Tnh Khnh Ha
16

Nha Khoa i Nam

55/1 Nguyn Thin Thut, Phng Lc Th, Tnh Khnh Ha


222 Trn Qu Cp, P. Ninh Hip, TX. Ninh Ha, Tnh Khnh Ha

Bnh Thun
17

Nha Khoa i Nam

90 - 92 Trn Hng o, Ph Thy, TP.Phan Thit, Tnh Bnh Thun

Ninh Thun
18

Nha Khoa i Nam

01 Cao B Qut, TP. Phan Rang, Tnh Ninh Thun

Gia Lai
19

Nha Khoa i Nam

12-14 Trn Ph, P. Ty Sn, TP. Pleiku, Tnh Gia Lai

Nng
20

Nha Khoa i Nam

328 ng ch Khim, P. Vnh Trung, Q. Thanh Kh, TP. Nng

21

Nha khoa Ton M

348 ng a, Qun Hi Chu, Nng

22

Nha khoa V Duy Hng

26 Hm Nghi, Phng Thanh Kh, Nng

23

Nha khoa Happy

s 26 Hm Nghi, Tp. Nng

24

Nha khoa V nh Chu

TP. Nng

25

Nha khoa V Duy Hng

TP. Nng

Bn Tre
26

Nha Khoa Ton

182A5 ng trnh QL.60,KP.3,P.Ph Tn,TP.Bn Tre

Tr Vinh
27

Nha Khoa Ton

126B Nguyn ng, Khm 8, P.6, TP Tr Vinh

Bc Liu
28

Nha Khoa Ton

95/5 ng Trn Ph, Khm 5, P.7 , TP Bc Liu

Vng Tu
29

Nha Khoa Vit Nht

11/1 Tn Ph, Ph M, B Ra - Vng Tu

30

Nha khoa Trn Vn Bnh

493 Nguyn An Ninh - TP Vng Tu

31

Nha khoa Ph Thnh

400 Trng Cng nh - P8- TP Vng Tu

32

Nha khoa Si Gn

114 Nguyn Vn Tri- P4- TP Vng Tu

33

Nha khoa Hong An

8 Ba Cu- TP Vng Tu

34

Nha khoa Tm c

Chi nhnh Vng Tu: 102 Ba Cu - P3- TP Vng Tu

35

Nha khoa Hng Phc

246 ng 30/4- P Rch Da- TP Vng Tu


Trang 20 / 21

36
37
38

Nha khoa Bi nh Bnh


Nha khoa Thnh Pht - Vit
M
PK a khoa Vit Tm

E3-2/7 TT th Ch Linh- P10- Vng Tu


135 L Hng Phong- P8- Vng Tu
QL51- p Phc Thnh - X M Xun - Huyn Tn Thnh - B Ra
Vng Tu

6. A CH LIN H
1. CNG TY MI GII BO HIM AON VIT NAM:
a ch: P.702, Ta nh Sailing, 111A Pasteur, Q.1, Tp. H Ch Minh
in thoi: (08) 3 822 4884 Fax: (08) 3 822 2700
S in thoi h tr (Aon Helpdesk): (08) 3822 1283 / 3822 1175
0903 333 951/ 091 814 1477

2. CNG TY BO HIM PVI:


Thc mc v tnh trng h s:
TNG CNG TY BO HIM PVI
VP I DIN CSKH BH PVI PHA NAM
Lu 02-03, Ta nh Thnh, 81 Cao Thng, P.03, Q.03, TP.HCM
in thoi: (08) 6290 9118
Hotline h tr bo lnh vin ph: 1900 54 54 58

*S tay ny ch mang tnh tham kho v khng c gi tr thay th hoc b sung hp ng bo


him hin ti*

Trang 21 / 21