Republika Srpska Health Insurance Fund and Atlas hospital

Health Insurance Fund of the Republic of Srpska and Atlas

17-08-2016

The right to treatment of insured persons from the Republic of Srpska in the general hospital “Atlas” on the expense of the Health Insurance Fund of the Republic of Srpska. RS Fund and Atlas General Hospital.

Insured persons of the Health Insurance Fund of the Republic of Srpska have right to treatment in Atlas General Hospital in case the treatment can not be performed in health institutions of Republic of Srpska.

Procedure

The procedure for referral to Atlas General Hospital is following:

  • Health institution from Republic of Srpska (medical consilium) where patient is treated gives suggestion that the treatment should be done out of Republic of Srpska, considering the fact that treatment can not be done in Republic of Srpska.
  • Suggestion, together with necessary documentation, health institution forwards to the Fund. 
  • Suggestion is then considered by special board of the Fund that takes decision about the approval of treatment, and decision is sent to the address of the patient, or patient can take it in the office of the Fund.  
  • After receiving referral needed for the treatment, it is necessary for patient to contact the call center of Atlas General Hospital, so that consultation with our doctors can be made, and eventually make reservation for the operation.    
  • For first consultation it is necessary to bring the original of referral for hospital treatment with all medical documentation. 

What the insurer pay?

For insured persons who have been granted treatment outside the RS in institutions that have a contract with the Fund, the Fund finances the costs in full, except for the participation paid by insured persons who are not exempted from this obligation.

Insured persons to whom treatment is approved outside of the Republic of Srpska that have contract with the Fund, the Fund covers costs completely, except participation that the patient pays  when they are not freed  from this obligation (participation).

Treatment on personal request 

The exception is treatment outside the RS for the personal request of the insured, when the Fund finances 30% of the costs of treatment, and the insured bears 70% of the costs, because the treatment could have been carried out in the RS, and the insured insisted that it should be performed at an institution outside the RS. Treatment outside the RS on the personal request of the insured is also granted for those institutions with whom the Health Insurance Fund of Republic of Srpska.