Step

Establish direct billing arrangement

Responsible Party

Resident Representative,

Human Resources Management,

UN Insurance Unit,

MIP Administrator,

UN Medical Services ( DHMOSH)

Template/Guideline

Explanatory Notes

Responsible parties are:  RR and third party MIP administrator in consultation with OHR, UNMSD and UN Insurance Unit

Step

Pre-certification for medical treatment at UN Clinic

Responsible Party

Template/Guideline

Explanatory Notes

Step

Charge insurance for medical services received at UN Clinics

Responsible Party

MIP Administrator

Template/Guideline

Explanatory Notes

The service providers administering the various UN insurance plans will treat the charges associated with the provision of clinic services in the same manner as other medical services. When determining billable services associated with a UN Clinic, reference should be made to the benefits and limitations under the respective UN insurance plans.

The reasonable and customary charges will be determined on the basis of nationally established pricing tariffs or, where no national tariffs exist, market rates and/or a database of pricing determined by the insurance scheme.

The rules and procedures by which the insurance will reimburse for such services must be adhered to.

Responsible party is the Third party MIP administrator.

Step

Pay co-payment or out of pocket portion for medical services received at UN Clinic

Responsible Party

Staff member

Template/Guideline

Explanatory Notes

Step

Certification of co-payment bills

Responsible Party

Template/Guideline

Explanatory Notes

The bills must include the official stamp and signature of the attending physician (i.e., not of the nurse).

Responsible party is the Attending UN Clinic Physician.