Rules and clinical protocols 
Frequently Asked Questions Frequently Asked Questions
1. Are cosmetic CSHI surgeries covered in private clinics?
Specialized medical care in outpatient settings within the framework of the GOBMP and (or) in the OSMS system is provided as planned at the primary, secondary and tertiary levels of medical care in the direction of specialists providing medical care at the primary and secondary levels in accordance with the reasons for the appeal (Order of the Ministry of Health of the Republic of Kazakhstan No. KR DSM-37 "On approval of the rules providing specialized medical care on an outpatient basis."
The reason for the appeal may be illness, injury, prevention, dynamic monitoring, medical and social services, administrative, examination for coronavirus infection (Appendix 4 to the Order of the Acting Ministry of Health of the Republic of Kazakhstan No. 49 "On approval of the Standard for the organization of primary health care in the Republic of Kazakhstan" (hereinafter - the Order).
When contacting a polyclinic for examinations before a cosmetic operation or procedure, this reason for contacting is not a disease and is not included in the list of the above-mentioned Order and cannot be provided by the polyclinic within the framework of the GOBMP OSMS system.
A source:
Order of the Ministry of Health of the Republic of Kazakhstan No. KR DSM-37 "On approval of the rules for the provision of specialized medical care in outpatient settings
The reason for the appeal may be illness, injury, prevention, dynamic monitoring, medical and social services, administrative, examination for coronavirus infection (Appendix 4 to the Order of the Acting Ministry of Health of the Republic of Kazakhstan No. 49 "On approval of the Standard for the organization of primary health care in the Republic of Kazakhstan" (hereinafter - the Order).
When contacting a polyclinic for examinations before a cosmetic operation or procedure, this reason for contacting is not a disease and is not included in the list of the above-mentioned Order and cannot be provided by the polyclinic within the framework of the GOBMP OSMS system.
A source:
Order of the Ministry of Health of the Republic of Kazakhstan No. KR DSM-37 "On approval of the rules for the provision of specialized medical care in outpatient settings
2. Is it possible to issue a sick leave to those who do not have the status of insurance in the MSHI system?
If, in order to establish or confirm the disability of the patient, the provision of medical services in the OSMS system is not required, then the sick leave must be issued within the framework of the GOBMP.
For example, an uninsured patient showed signs of acute respiratory viral infection, and he applied for an appointment in a filter room or to a local doctor. If a referral to a specialist or diagnostic tests, which are included in the MSHI package, are not required to establish a diagnosis, then the patient may be prescribed a sick leave by the district doctor.
However, if for further adjustment of treatment or additional research it is necessary to receive medical services included in the list of CSHI, then such a patient will need to obtain the status of insurance in the CSHI system.
Source: Order of the Minister of Health of the Republic of Kazakhstan dated November 18, 2020 No. KR DSM-198/2020.
For example, an uninsured patient showed signs of acute respiratory viral infection, and he applied for an appointment in a filter room or to a local doctor. If a referral to a specialist or diagnostic tests, which are included in the MSHI package, are not required to establish a diagnosis, then the patient may be prescribed a sick leave by the district doctor.
However, if for further adjustment of treatment or additional research it is necessary to receive medical services included in the list of CSHI, then such a patient will need to obtain the status of insurance in the CSHI system.
Source: Order of the Minister of Health of the Republic of Kazakhstan dated November 18, 2020 No. KR DSM-198/2020.
3. Where can I get a sick leave for pregnant women who have temporarily left their permanent place of residence?
A temporary disability certificate (or extended) in a women's clinic where a pregnant woman is temporarily observed or in a medical organization where the birth took place (basis: extract or exchange card fr om the medical organization wh ere the birth took place).
Source:
"On approval of the standard for the organization of surgical (abdominal, thoracic, coloproctological) care in the Republic of Kazakhstan"
Order of the Minister of Health of the Republic of Kazakhstan dated March 20, 2023 No. 41.
Source:
"On approval of the standard for the organization of surgical (abdominal, thoracic, coloproctological) care in the Republic of Kazakhstan"
Order of the Minister of Health of the Republic of Kazakhstan dated March 20, 2023 No. 41.
4. Часто болеющему ребенку положена ли путевка в санаторий по ОСМС? Ребенок на учете не состоит, семья многодетная. Болеет часто орви, орз, ангина. Одну справку закрываем, через 3-4 дня опять заболевает
Sanatorium-resort institutions of the Republic of Kazakhstan do not participate in the GOBMP and OSMS
• The rules for providing sanatorium treatment to persons with disabilities and children with disabilities are regulated by the Order of the Deputy Prime Minister - Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated June 30, 2023 No. 283 (Chapter 1, paragraph 3)
• Spa treatment is provided on the basis of an Individual Habilitation and Rehabilitation Program (IPAR) for persons with disabilities
• The rules for providing sanatorium treatment to persons with disabilities and children with disabilities are regulated by the Order of the Deputy Prime Minister - Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated June 30, 2023 No. 283 (Chapter 1, paragraph 3)
• Spa treatment is provided on the basis of an Individual Habilitation and Rehabilitation Program (IPAR) for persons with disabilities
5. Может ли врач выдать 5-6 направлений по услуге «определение специфических IgE к прочим аллергенам ИФА методом», и не будет ли это считаться дефектом?
No, the formation of 5-6 referrals for one service is not considered a defect if they are justified by medical indications. The doctor can issue directions for tests to determine the level of specific IgE to different allergens, specifying the necessary allergens.
It is important that the specialist substantiates the need for each analysis. If the diagnosis requires determining the IgE level for each allergen, the doctor may issue a separate referral for each. Thus, it is acceptable if it meets the diagnostic needs.
6. If a patient does not have Kazakhstani citizenship but is insured, is he served only under the VMS (voluntary medical insurance) contract?
Если пациент без гражданства Казахстана застрахован в системе ОСМС, он имеет право на медицинскую помощь в рамках ОСМС. Если у него только ВМС, то он получает помощь по условиям договора ВМС.
Источники: Статьи 83, 201 Кодекса Республики Казахстан «О здоровье народа и системе здравоохранения».
7. A mother caring for her 4-year-old child in the hospital needs a sick leave certificate. Who issues the sick leave in this case: the hospital or the clinic of attachment?
Больничный лист выдается медицинской организацией, в которой ребенок проходит лечение.
8. Who conducts the dynamic examination of patients registered with oncology, specifically (CT, MRI)? The clinic of attachment or the oncology dispensary?
Dynamic monitoring of patients with oncological diseases, including CT and MRI, is carried out both in PHC (primary health care) organizations and in oncological dispensaries.
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated October 23, 2020 No. KR DSM-149/2020 “On approval of the rules for the organization of medical care for persons with chronic diseases, frequency and timing of follow-up, mandatory minimum and frequency of diagnostic tests”
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated October 23, 2020 No. KR DSM-149/2020 “On approval of the rules for the organization of medical care for persons with chronic diseases, frequency and timing of follow-up, mandatory minimum and frequency of diagnostic tests”
9. Which order regulates the work of the registration office?
The work of the registry is regulated by the standard for the organization of primary health care in the Republic of Kazakhstan, approved by Order No. 49 of the Acting Minister of Health of the Republic of Kazakhstan dated March 30, 2023
10. If a patient's complaint is unfounded, why is it displayed in the statistics?
The general statistics show all complaints received by the Fund.
However, when dividing into classifications, the fact that the complaint is unfounded is taken into account.
However, when dividing into classifications, the fact that the complaint is unfounded is taken into account.
11. The patient is pregnant, the term is 13 weeks. She lives at one address, but is registered at another. She rents an apartment and is not officially registered at the place of actual residence. In which medical institution should she be registered for pregnancy: at the place of residence or at the place of residence?
The patient needs to attach herself to the polyclinic at her place of residence, and then register for pregnancy with a gynecologist. The clinic where the patient was attached should do the following:
Record the actual address of the patient in the exchange card (forms No. 077/y and No. 048/y).
Inform the local health authorities and medical organizations about the move to the new address.
A source: Order of the Ministry of Health of the Republic of Kazakhstan dated August 26, 2021 No. KR DSM-92 “On approval of the standard for the organization of obstetric and gynecological care in the Republic of Kazakhstan”
Record the actual address of the patient in the exchange card (forms No. 077/y and No. 048/y).
Inform the local health authorities and medical organizations about the move to the new address.
A source: Order of the Ministry of Health of the Republic of Kazakhstan dated August 26, 2021 No. KR DSM-92 “On approval of the standard for the organization of obstetric and gynecological care in the Republic of Kazakhstan”
12. Может ли незастрахованный человек бесплатно получить флюорографию?
Yes, an uninsured person can undergo fluorography if he is part of a population group with a high risk of the disease, subject to mandatory annual fluorographic examination for tuberculosis, according to paragraph 80 of paragraph 3 of Chapter 2 of Order No. 214 "On approval of the rules for the prevention of tuberculosis".
They can also undergo screening (additional screening of the rural population) for early detection of respiratory diseases, according to Order No. 174 "On approval of target groups of persons subject to screening studies, as well as the rules, scope and frequency of these studies."
They can also undergo screening (additional screening of the rural population) for early detection of respiratory diseases, according to Order No. 174 "On approval of target groups of persons subject to screening studies, as well as the rules, scope and frequency of these studies."
13. How to work off the assets of the deceased? If a person died in a hospital, will this be considered an asset postscript, since it occurs after the date of death?
In case of death of a person in a hospital, the medical institution in which he was treated is responsible for informing the polyclinic in which he was registered. Upon receiving notification of the patient's death, the polyclinic must close his medical record and update information about his status.
Since home visits are not possible due to the death of a patient in the hospital, the polyclinic can close the asset by updating information about the patient's status and specifying the date and cause of death. This can be done on the basis of medical documentation provided by the hospital, including a death certificate and a medical record of the inpatient.
14. A citizen of Kyrgyzstan whose residence permit expired in 2023 needs hospitalization for childbirth. Does she have to pay, or can she receive assistance for free?
Yes, she is entitled to free emergency and emergency medical care, including childbirth in case of an emergency. For planned hospitalization and delivery without emergency indications, payment for medical services may be required.
Temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of the international Treaty of the EAEU, enjoy the rights and bear responsibilities in the CSHI system on an equal basis with citizens of the Republic of Kazakhstan.
Source: Article 83 of the Code of the Republic of Kazakhstan "On the health of the people and the health care system".
Temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of the international Treaty of the EAEU, enjoy the rights and bear responsibilities in the CSHI system on an equal basis with citizens of the Republic of Kazakhstan.
Source: Article 83 of the Code of the Republic of Kazakhstan "On the health of the people and the health care system".
15. A patient at 30 weeks of pregnancy, attached to another clinic, visited and gave birth. Our clinic issued a sick leave at the time of discharge. Now the clinic is demanding to issue a sick leave for the 56-day postpartum period. How legitimate is this?
The clinic's requirement to issue a sick leave for the postpartum period of 56 days is legitimate. The medical organization where the birth took place must issue a sick leave for the entire postpartum period in accordance with the legislation of the Republic of Kazakhstan.
Sources: Order of the Ministry of Health of the Republic of Kazakhstan dated November 18, 2020 No. KR DSM-198/2020 “On approval of the rules for the examination of temporary disability, as well as the issuance of a sheet or certificate of temporary disability.”
Sources: Order of the Ministry of Health of the Republic of Kazakhstan dated November 18, 2020 No. KR DSM-198/2020 “On approval of the rules for the examination of temporary disability, as well as the issuance of a sheet or certificate of temporary disability.”
16. The patient was discharged fr om the hospital after surgery. Dressings have been prescribed. Does the clinic of attachment issue the referral for dressings, or does the organization wh ere the surgery was performed?
A patient discharged from the hospital after surgery with an appointment for bandages should receive a referral for bandages at the polyclinic at the place of attachment.
Source: Order of the Acting Ministry of Health of the Republic of Kazakhstan dated March 30, 2023 No. 49 “On approval of the Standard for the organization of primary health care in the Republic of Kazakhstan”.
Source: Order of the Acting Ministry of Health of the Republic of Kazakhstan dated March 30, 2023 No. 49 “On approval of the Standard for the organization of primary health care in the Republic of Kazakhstan”.
17. How will the service "A01.010.000 'Reception: Nurse with secondary education' be paid?
In accordance with Order No. 37, the service A01.010.000 "Admission: A nurse with secondary education" is provided in youth health centers and is paid according to the tariff in the OSMS system. If the nurse works in the district service, she is paid at the expense of the CPN, if the patient is provided with services in the ICZ, then at the rate.
18. In which order is it stated that 50% of the KDU plan should be spent on co-execution?
In the Procurement Rules, paragraph 62 prescribes the volume of transfer of services to the CDU for co-fulfillment, where 60% of the total amount of the contract is transferred to district organizations and 50% to urban entities with a population of 30,000 and above.
Source: Order of the Minister of Health of the Republic of Kazakhstan dated December 8, 2020 No. KR DSM-242/2020 “On Approval of the Rules for the purchase of services from healthcare entities for the provision of medical care within the framework of GOBMP and (or) in the OSMS system”
Source: Order of the Minister of Health of the Republic of Kazakhstan dated December 8, 2020 No. KR DSM-242/2020 “On Approval of the Rules for the purchase of services from healthcare entities for the provision of medical care within the framework of GOBMP and (or) in the OSMS system”
19. What is the algorithm for attaching to a PHC subject?
The patient can attach to the PHC at the place of residence by contacting in person or submitting via the E-gov web portal.
attachment to a polyclinic https://egov.kz/cms/en/services/494pass_mz?mobile=no
attachment to a polyclinic https://egov.kz/cms/en/services/494pass_mz?mobile=no
Пациент может прикрепиться к ПМСП по месту проживания, обратившись лично или подать через веб-портал E-gov.
Пациент получит талон или уведомление через E-gov о прикреплении, либо мотивированный отказ.
Источник: Приказ МЗ РК от 13 ноября 2020 года № ҚР ДСМ-194/2020” Об утверждении правил прикрепления физических лиц к организациям здравоохранения, оказывающим первичную медико-санитарную помощь”
20. The child is 6 years old, but he is not included in the candidate's age profile. Do I need to open a disease record and refer to specialists for non-existent diagnoses?
Occupational examination is provided for children aged 5 to 6 years and from 6 to 7 years. Thus, carrying out a preventive examination for children aged 6 years meets the established requirements and is not a defect.
Source: According to the Appendix to the rules, the volume and frequency of preventive medical examinations of target groups of the population, including children of preschool, school age, as well as students of organizations of technical and vocational, post-secondary and higher education.
Source: According to the Appendix to the rules, the volume and frequency of preventive medical examinations of target groups of the population, including children of preschool, school age, as well as students of organizations of technical and vocational, post-secondary and higher education.
