North Macedonia Health Insurance Fund increases controls on medical billing

The Health Insurance Fund in North Macedonia is intensifying inspections of contracted healthcare institutions to prevent the unjustified charging of medical services. The primary focus of these controls is to identify irregularities in billing for services already covered by mandatory health insurance.

Authorities are specifically looking for instances of double billing, where both the Fund and the insured individual are charged for the same service. The Fund reminded citizens that for services covered by mandatory insurance, patients are only required to pay the legally established personal participation fee, if applicable.

Healthcare facilities are obligated to display information regarding participation fees in a visible and accessible location and must provide legal proof of payment for all services rendered. The Fund stated it will take appropriate measures against institutions found to be in violation of contractual obligations or legal regulations.