NHSO shortcuts COVID-19 claim processing time
 
Last year, the National Health Security Office (NHSO) began adjusting its claim system to help hospital operators get quick funds for COVID-19 health services, including mass testing and emergency care. 
 
In the pandemic, the NHSO has acted as a clearinghouse for the Thai government's three healthcare schemes Universal Coverage scheme, Social Security Scheme and Civil Servant Medical Benefits, which combine cover healthcare for more than 99% of the Thai population.  
 
The NHSO took around a month to review claim documents and transfer the fund to hospital operators before the COVID-19 outbreak in 2020. However, the rising demand for emergency care during the pandemic, also increasing the hospitals' operation cost, pushed the NHSO to accelerate its transaction process.
 
It could eventually reduce the claim processing time from one month to two weeks. But this is not fast enough to ensure hospitals' financial liquidity, especially during the recent surge of Omicron cases. 
 
On Feb 17, the NHSO board chaired by Deputy Prime Minister and Public Health Minister Anutin Charnvirakul decided to introduce a one-day claim system in which hospital operators will be reimbursed for medical expenses incurred from COVID-19 health services within a day. The transactions will be made online. 
 

To pay hospitals faster, said the NHSO Secretary-General Dr Jadej Thammatacharee, his team had worked with the Public Health Ministry to revise the claim and payment guidelines.
 
The revisions include the avoidance of applying Diagnosis Related Group (DRG) payment in mild-symptom coronavirus cases. Medical expenses incurred from these cases will be paid in a lump sum, reducing the time spent on claim document reviews.
 
For example, a hospital providing less than six days of treatment to a mild-symptom patient will receive 6,000 baht per case, and 12,000 baht for a case requiring more than seven days of treatment.    
 
Similarly, lump-sum payment is applied with COVID-19 tests and patients' rooms. Hospital operators can claim 250 and 350 baht per test when using chromatography and FIA antigen test kits, respectively. 
 
Around 900 and 1,100 baht will be paid to health units providing RT-PCR tests that detect two and three viral genes, respectively. The amount of payment may be adjusted due to the testing's cost reduction.
 
Recently, the NHSO has set a new guideline for paying health units providing self-test kits to people at risk of COVID-19. Health units  including hospitals, clinics and pharmacies partnering with the NHSO   can claim 55 baht per unit of self-test kit. 
 
They are encouraged to purchase the devices under the government's 'innovation list"  the list of innovative goods and services that involve Thai people or organizations in their development. These items are quality guaranteed by the Thai government. Purchasing them will help support the local producers and encourage more research and development.
 
Hospitals providing rooms to COVID-19 patients will be paid based on their severity of symptoms, classified into five levels. They will also get 550 baht to cover a set of personal protective equipment.
 
In addition, the NHSO has covered the cost of transporting mild-symptom patients 1,900 baht per day for a non-emergency transport vehicle or a for-hire vehicle that is not an ambulance. This vehicle, of which a driver must adopt hygiene and safety guidelines, can fill up the gap left by limited numbers of available ambulances during the pandemic.
 
Dr Jadej said that the new payment guidelines would help the NHSO process the transaction quicker. It also relieves the financial burden for the government which covers medical fees for every Thai.
 
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