We would like to express our sincere gratitude for your understanding and cooperation in Kita Ward's vaccination program. We publish various styles for medical institutions.
About the form of "Request and Receipt Notification"
Medical institutions that are vaccinated with the new coronavirus vaccine are required to send the following document "Notification regarding billing and receipt of expenses related to new coronavirus vaccination". If you have already sent the medical institution, please submit it again if it falls under any of the following. Please submit it to the following Kita Ward Public Health Center and National Health Insurance Federation.
[When submission is required]
- Change of medical institution name
- Change of medical institution location
- Change of phone number/fax number
- Change of representative
- Change of payee (change of bank account, account number, etc.)
In addition, if there is a change in the above medical institution information, a separate procedure for changing V-SYS is required at your hospital.
About forms such as requests for inoculation of new corona vaccine after hours and holidays
On June 23, 2021, the Ministry of Health, Labor and Welfare Health Bureau, Health Division, Health Division, Vaccination Office Office Communication indicated how to claim additional vaccination costs related to "vaccination of new coronavirus vaccines after hours and on holidays." The billing method is as follows.
[Important] Please use the old medical checkup form (the medical checkup form does not have a column for after-hours/holidays) and count only the number of times you received vaccinations during overtime/holidays before making a request. I will.
Regarding the expenses for overtime/holiday vaccinations carried out using the new form of pre-examination form, you will be billed as a monthly vaccination fee using the billing form that must be entered and submitted using V-SYS. Please do not include it in the book.
[April/May (2020)] Forms such as invoices for overtime/holiday vaccinations
Invoice (Form 1) and performance report (Form 2) [for April and May]
The form can be downloaded from the file below.
- Invoice/Actual Report (Form 1/2) (Excel: 26KB)
- [Description example] Invoice / performance report (PDF: 227KB)
- About filling out invoices and performance reports (PDF: 756KB)
[June and later (2020)] Forms such as bills for overtime/holiday vaccinations
Invoice (Form 1) and performance report (Form 2) [from June onwards]
The form can be downloaded from the file below.
- Invoice/Actual Report (Form 1/2) (Excel: 29KB)
- [Description example] Invoice / performance report (PDF: 359KB)
- About filling out bills and performance reports (PDF: 909KB)
The form of the invoice has changed since June 2022. From June onwards, please prepare and submit invoices and performance reports for each month .
(Ex. If both June and July are applicable ⇒ Please prepare and submit invoices and performance reports for each month of vaccination in June and July.)
Submission of the above request form (submission by mail)
Kita Ward Public Health Center Novel Coronavirus Vaccination Division 2-7-3 Higashijujo 114-0001 Kita Ward Public Health Center
Please fill in the invoice and performance report, sign it, and mail it to the above address by the deadline.
About payment for new and old medical examination slips
There are two types of vaccination slips, the new style and the old style. The billing method for after-hours/holiday inoculation costs differs depending on each pre-examination slip. For details on the billing method, please check the payment flow below.
【reference】
Click here for the old and new ticket.
About preventing mistakes when inoculating the new corona vaccine
In the implementation of vaccination, we are working to maintain a system that can prevent mistakes related to vaccination and quickly grasp the occurrence of mistakes based on various procedures.
Recently, regarding those who were mistakenly vaccinated with the new coronavirus vaccine to those who came to receive other vaccines, the government has compiled an overview and specific points to note, and has issued a notification to ensure that relevant organizations are thoroughly informed.
We ask that each medical institution continue to strive to prevent mistakes from occurring.
Related Links
About new coronavirus vaccination (return to top page)
About the third new coronavirus vaccination
About the 3rd vaccination for medical workers
Ministry of Health, Labor and Welfare homepage (we link to the outside site)
Prime Minister's official residence homepage (we link to the outside site)
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Affiliation: Kita Ward Public Health Center New Coronavirus Vaccination Division