The principle “money follows the patient” helps to implement the electronic health care system (EHS), which ensures the transparency of the provision of medical services and transparent payment for them.
Doctors connect to the central database of the EHOS through medical information systems, and Helsi is one such system. Patients can track data about their health with the help of such systems.
It is in the electronic health care system that doctors enter data about the services provided to the patient, and the state, represented by the National Health Service (NHSHU), pays for them.
Most of the records that patients consider to be incorrect are actually appointments, during which information about vaccinations, procedures, or passing a medical board, etc., was entered into the system. Do not confuse them with fake visits.
Of course, in the process of doctors’ work with the system, visit data may appear by mistake due to the human factor, and may be an abuse on the part of doctors, for which liability is assumed in accordance with the law.
“Physicians who provide services under the medical guarantee program keep records in the ESOZ. The doctor seals the entered data with his electronic signature and, accordingly, is responsible for their authenticity. – Deputy Minister of Health Maria Karchevych comments. – Monitoring of such records according to various algorithms, including automatic ones, is carried out by NSZU. In the case of entering unreliable data, manipulation of numbers, recalculations of funds are carried out. If they are confirmed, NSZU can reduce the amount of payments in accordance with the requirements of the contract and revise it. Information can also be passed on to law enforcement agencies.”
In the last year alone, 16,670 repeat records on the “primary” were discovered by the NSZU – this made it possible to avoid overpayments of over 5 million hryvnias.
More than half a million patient death records were also reviewed. Thanks to this, the funds were not spent on services for “dead souls”. This made it possible to redistribute UAH 158 million.
So, if you noticed a fake visit in your personal account, you need to:
– If you are convinced that you did not receive any services, file a complaint with the National Health Service at number 16-77, or at the link: https://service.e-health.gov.ua/gromadyanam
– You can also file a written complaint directly with the management of the medical institution where you were assigned a fake visit.
These actions will help the state to respond more quickly and send monitoring teams to medical institutions that receive numerous complaints
