Application of information technology in inspection and examination of Social Insurance and Health Insurance
(Baonghean.vn) - Recently, the inspection and examination work of Nghe An Provincial Social Insurance has made an important contribution to ensuring the rights of participants and beneficiaries of Social Insurance and Health Insurance policies.
The application of information technology and conversion of inspection and examination methods have been actively deployed by the provincial Social Insurance sector and have proven effective.
Converting inspection and control methods
In 2023, the whole province will have more than 3 million people participating in Social Insurance, Health Insurance, Unemployment Insurance and more than 5 million visits to Health Insurance for medical examination and treatment. The large number of employers, participants and beneficiaries of the regimes has put considerable pressure on the inspection and examination work of the provincial Social Insurance sector.
With the traditional inspection and examination method as before, inspection and examination teams had to prepare documents, records, forms and work directly with the unit to compare information and data manually on books and paper documents in very large quantities. Therefore, only a certain number of records could be checked probabilistically due to time constraints. Applying information technology to proactively review and analyze data before working directly with the unit helps inspection and examination teams evaluate, delimit, and select samples that need to be inspected in practice, reducing the amount of records, papers, and documents that need to be compared, saving time, human resources, and material resources for both inspection and examination teams and units.
With the ability to review and analyze big data, the application of information technology has helped inspection teams, examine and control 100% of professional records (including for businesses with thousands of employees or medical examination and treatment facilities with millions of health insurance examination and treatment visits). Thereby, errors and violations that were previously difficult to detect or impossible to detect by traditional methods have been detected, such as: Using a health insurance card to simultaneously examine outpatients at many medical examination and treatment facilities; using one health insurance card to pay for medical examination and treatment costs with high frequency; medical staff practicing at the same time at many medical examination and treatment facilities... In particular, thanks to the application of information technology, loopholes in management or limitations in the implementation of professional procedures of the Social Insurance agency have been promptly detected, thereby recommending adjustments and amendments.
The application of information technology has helped inspection teams increase their productivity, improve their ability to detect and identify signs of errors and violations comprehensively; thereby helping to improve the quality and effectiveness of inspections and checks. At the same time, it significantly shortens the time of inspections and checks, ensuring the principle of not affecting the normal operations of the inspected and checked subjects.
In 2023, the Provincial Social Insurance conducted specialized inspections at 190 employers; inspected 70 employers, 20 health insurance examination and treatment facilities, 05 collection and payment representative service organizations and 03 district-level Social Insurance agencies; conducted interdisciplinary inspections of 30 employers; conducted surprise specialized inspections at 160 employers that were late in paying social insurance, health insurance, and unemployment insurance.
Through inspection and examination, the employer was required to pay over 52.2 billion VND in late payment of social insurance, unemployment insurance, and health insurance; pay back due to non-payment or underpayment for 96 employees with a total amount of over 1.5 billion VND; return to the Social Insurance and Unemployment Insurance funds due to incorrect benefits for 224 employees with an amount of over 368 million VND; and pay back to the Health Insurance fund due to incorrect payments of over 13.7 billion VND.
The Director of the Provincial Social Insurance has issued a Decision to sanction administrative violations against 43 employers who violated the law on social insurance, unemployment insurance, and health insurance with an administrative fine of VND 933.6 million; issued 14 Decisions to enforce the Decision to sanction administrative violations with an enforced fine of more than VND 1.6 billion.
Continue to improve the effectiveness of inspection and control work
In addition to direct inspection and examination at units, the Provincial Social Insurance also deployed a variety of measures to ensure the effectiveness of inspection and examination work such as: Inviting units with social insurance, health insurance, and unemployment insurance debts to work at the Provincial Social Insurance agency to urge units to fulfill their social insurance payment obligations and disseminate legal regulations and sanctions for violations. Through the working sessions, enterprises were very active in sharing and exchanging information to jointly aim at the goal of social security for workers in the area. The Provincial Social Insurance will accompany and support enterprises to create more favorable conditions in learning and effectively implementing policies and regimes of social insurance, health insurance, and unemployment insurance.
With a large number of employers and social insurance and health insurance participants, the application of information technology, method conversion, and diversification of inspection and examination forms are truly important solutions, contributing to improving the management efficiency of the Nghe An Social Insurance sector. Along with the increasingly improved and interconnected system of professional software throughout the sector, the use of technology solutions and information technology software tools has facilitated the comparison and reconciliation of data to serve the inspection and examination work in a timely, safe, and effective manner.
Implementing the direction of Vietnam Social Security, in the coming time, in addition to improving the qualifications and expertise of the inspector team, Nghe An Social Security will continue to apply information technology in all fields in general, promote the application of technological solutions in performing inspection and examination tasks to improve methods, increase efficiency, shorten working time while still ensuring compliance with the legal regulations on inspection and handling of administrative violations, contributing to ensuring the rights of workers and ensuring social security in the province./.
