{"id":340764,"date":"2025-03-24T08:32:54","date_gmt":"2025-03-24T07:32:54","guid":{"rendered":"https:\/\/zakrasnejsivimperk.cz\/?p=340764"},"modified":"2025-03-24T08:35:08","modified_gmt":"2025-03-24T07:35:08","slug":"vseobecna-zdravotni-pojistovna-schvalovani-navrhu-na-lazne","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=340764","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Schvalov\u00e1n\u00ed n\u00e1vrhu na l\u00e1zn\u011b"},"content":{"rendered":"

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OT\u00c1ZKA:<\/h6>\n
Jak prob\u00edh\u00e1 schvalov\u00e1n\u00ed l\u00e1zn\u00ed?<\/b><\/h6>\n
ODPOV\u011a\u010e:<\/h6>\n
Aby mohla zdravotn\u00ed poji\u0161\u0165ovna pacientovi schv\u00e1lit pobyt v\u00a0l\u00e1zn\u00edch, mus\u00ed mu nejprve o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 n\u00e1vrh na l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di napsat, a to na z\u00e1klad\u011b posouzen\u00ed jeho aktu\u00e1ln\u00edho zdravotn\u00edho stavu a\u00a0zhodnocen\u00ed p\u0159\u00ednos\u016f a\u00a0rizik l\u00e1ze\u0148sk\u00e9 p\u00e9\u010de.\u00a0<\/b>N\u00e1sledn\u011b o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 tento n\u00e1vrh na\u00a0l\u00e1ze\u0148skou p\u00e9\u010di odes\u00edl\u00e1 zdravotn\u00ed poji\u0161\u0165ovn\u011b ke schv\u00e1len\u00ed (na\u00a0smluvn\u011b a m\u00edstn\u011b p\u0159\u00edslu\u0161n\u00e9 region\u00e1ln\u00ed pracovi\u0161t\u011b VZP<\/a>).<\/b><\/h6>\n

L\u00e1ze\u0148sk\u00e1 l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010de je hrazena z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed v\u00a0p\u0159\u00edpad\u011b, \u017ee\u00a0jde o nezbytnou sou\u010d\u00e1st l\u00e9\u010debn\u00e9ho procesu. Podm\u00ednky \u00fahrady l\u00e1zn\u00ed pro d\u011bti a dosp\u011bl\u00e9 jsou stejn\u00e9 pro v\u0161echny zdravotn\u00ed poji\u0161\u0165ovny.<\/b><\/p>\n

Jak hodnot\u00ed zdravotn\u00ed poji\u0161\u0165ovna n\u00e1vrh na l\u00e1zn\u011b?<\/b><\/p>\n

Zdravotn\u00ed poji\u0161\u0165ovna posuzuje n\u00e1vrh na l\u00e1ze\u0148skou p\u00e9\u010di\u00a0<\/b>(pro d\u011bti a dosp\u011bl\u00e9)\u00a0a jeho \u00fahradu z\u00a0prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed dle z\u00e1kona o ve\u0159ejn\u00e9m zdravotn\u00edm poji\u0161t\u011bn\u00ed\u00a0<\/b>(\u010d.\u00a048\/1997 Sb.)\u00a0a jeho P\u0159\u00edlohy \u010d. 5 \u2013 Indika\u010dn\u00edho seznamu pro l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di<\/b>. V\u00a0t\u00e9to p\u0159\u00edloze jsou specifikov\u00e1ny jednotliv\u00e9 indikace \u2013 tzn. nemoci a stavy, p\u0159i\u00a0kter\u00fdch lze poskytnout, resp. hradit z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di \u2013 d\u00e9lka l\u00e9\u010debn\u00e9ho pobytu, mo\u017enost jeho prodlou\u017een\u00ed, mo\u017enost opakov\u00e1n\u00ed l\u00e1ze\u0148sk\u00e9 l\u00e9\u010dby a jeho intervaly.<\/p>\n

Za jak dlouho mi poji\u0161\u0165ovna schv\u00e1l\u00ed n\u00e1vrh?<\/b><\/p>\n

Zdravotn\u00ed poji\u0161\u0165ovna se k n\u00e1vrhu na l\u00e1ze\u0148skou p\u00e9\u010di vyj\u00e1d\u0159\u00ed do 30 dn\u016f od obdr\u017een\u00ed n\u00e1vrhu, u\u00a0komplikovan\u011bj\u0161\u00edch p\u0159\u00edpad\u016f m\u016f\u017ee b\u00fdt lh\u016fta prodlou\u017eena na 60 dn\u016f.<\/b><\/p>\n

N\u00e1vrh na l\u00e1ze\u0148skou p\u00e9\u010di je schv\u00e1len\u00fd \u2013 co bude d\u00e1l?<\/b><\/p>\n

V\u00a0p\u0159\u00edpad\u011b, \u017ee jsou spln\u011bny v\u0161echny podm\u00ednky pro \u00fahradu z\u00a0prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed, je\u00a0n\u00e1vrh na l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di zdravotn\u00ed poji\u0161\u0165ovnou schv\u00e1len<\/b>.<\/p>\n

Komplexn\u00ed l\u00e1ze\u0148sk\u00e1 l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010de<\/u><\/p>\n

Schv\u00e1len\u00fd n\u00e1vrh na komplexn\u00ed l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di zas\u00edl\u00e1 p\u0159\u00edslu\u0161n\u00e9 region\u00e1ln\u00ed pracovi\u0161t\u011b VZP \u010cR p\u0159\u00edmo do l\u00e1ze\u0148sk\u00e9ho za\u0159\u00edzen\u00ed uveden\u00e9ho v n\u00e1vrhu na prvn\u00edm m\u00edst\u011b. Pokud tyto l\u00e1zn\u011b maj\u00ed voln\u00fd term\u00edn, vyrozum\u00ed pacienta zasl\u00e1n\u00edm tzv. \u201ep\u0159edvol\u00e1n\u00ed\u201c nejpozd\u011bji do 5 dn\u016f p\u0159ede dnem ur\u010den\u00e9ho n\u00e1stupu k\u00a0l\u00e1ze\u0148sk\u00e9mu l\u00e9\u010den\u00ed.<\/p>\n

L\u00e1zn\u011b sou\u010dasn\u011b pacienta informuj\u00ed o pr\u016fb\u011bhu l\u00e1ze\u0148sk\u00e9ho l\u00e9\u010den\u00ed (kde se bude v l\u00e1zn\u00edch hl\u00e1sit, co\u00a0je\u00a0t\u0159eba m\u00edt s sebou, \u017ee mus\u00ed b\u00fdt na\u00a0celou d\u00e9lku l\u00e1ze\u0148sk\u00e9ho l\u00e9\u010den\u00ed vybaven l\u00e9ky, kter\u00e9 trvale u\u017e\u00edv\u00e1, p\u0159ipoj\u00ed tak\u00e9 informace o\u00a0mo\u017enostech nadstandardn\u00edch slu\u017eeb s v\u00fd\u0161\u00ed \u00fahrady).<\/p>\n

V\u00a0p\u0159\u00edpad\u011b, \u017ee l\u00e1zn\u011b uveden\u00e9 v\u00a0n\u00e1vrhu na prvn\u00edm m\u00edst\u011b po\u0159ad\u00ed nemaj\u00ed k\u00a0dispozici l\u016f\u017eko v\u00a0\u010dasov\u00e9m rozmez\u00ed dan\u00e9m platnost\u00ed n\u00e1vrhu, jsou povinny cel\u00fd n\u00e1vrh odeslat do l\u00e1ze\u0148sk\u00e9ho za\u0159\u00edzen\u00ed uveden\u00e9ho na\u00a0m\u00edst\u011b druh\u00e9m \u2013 a tak d\u00e1le a\u017e po l\u00e1ze\u0148sk\u00e9 za\u0159\u00edzen\u00ed uveden\u00e9 jako posledn\u00ed v po\u0159ad\u00ed. Pokud by ani l\u00e1zn\u011b uveden\u00e9 jako posledn\u00ed v po\u0159ad\u00ed nem\u011bly voln\u00e9 l\u016f\u017eko pro pacienta, maj\u00ed povinnost odeslat n\u00e1vrh zp\u011bt na vys\u00edlaj\u00edc\u00ed region\u00e1ln\u00ed pracovi\u0161t\u011b VZP, kter\u00e9 danou situaci bude \u0159e\u0161it.<\/p>\n

P\u0159\u00edsp\u011bvkov\u00e1 l\u00e1ze\u0148sk\u00e1 l\u00e9\u010debn\u00e9 rehabilita\u010dn\u00ed p\u00e9\u010de<\/u><\/p>\n

U p\u0159\u00edsp\u011bvkov\u00e9 l\u00e1ze\u0148sk\u00e9 l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010de zpravidla zas\u00edl\u00e1 p\u0159\u00edslu\u0161n\u00e1 region\u00e1ln\u00ed pobo\u010dka VZP schv\u00e1len\u00fd n\u00e1vrh p\u0159\u00edmo pacientovi spolu se seznamem l\u00e1zn\u00ed a ten si vyb\u00edr\u00e1 l\u00e1ze\u0148sk\u00e9 za\u0159\u00edzen\u00ed s\u00e1m. Pacient si domlouv\u00e1 n\u00e1stup p\u0159\u00edmo s vybran\u00fdm\u00a0l\u00e1ze\u0148sk\u00fdm za\u0159\u00edzen\u00edm. U p\u0159\u00edsp\u011bvkov\u00e9 l\u00e1ze\u0148sk\u00e9 p\u00e9\u010de je\u00a0stanoven term\u00edn n\u00e1stupu l\u00e9\u010den\u00ed nejpozd\u011bji do\u00a0\u0161esti m\u011bs\u00edc\u016f ode dne schv\u00e1len\u00ed n\u00e1vrhu zdravotn\u00ed poji\u0161\u0165ovnou.<\/p>\n

Co m\u00e1m d\u011blat, kdy\u017e mi byly l\u00e1zn\u011b zam\u00edtnuty?<\/b><\/p>\n

Pokud zdravotn\u00ed poji\u0161\u0165ovna n\u00e1vrh na l\u00e1ze\u0148skou p\u00e9\u010di neschv\u00e1l\u00ed, tak odes\u00edl\u00e1 poji\u0161t\u011bnci a\u00a0o\u0161et\u0159uj\u00edc\u00edmu l\u00e9ka\u0159i rozhodnut\u00ed se zd\u016fvodn\u011bn\u00edm zam\u00edtnut\u00ed n\u00e1vrhu. Z\u00e1rove\u0148 tak\u00e9 p\u0159ipoj\u00ed pou\u010den\u00ed o mo\u017enosti pod\u00e1n\u00ed odvol\u00e1n\u00ed do 15\u00a0dn\u00ed od doru\u010den\u00ed tohoto rozhodnut\u00ed zdravotn\u00ed poji\u0161\u0165ovny poji\u0161t\u011bnci.<\/b>\u00a0Podat odvol\u00e1n\u00ed m\u016f\u017ee i poji\u0161t\u011bnec. Pod\u00e1-li odvol\u00e1n\u00ed jin\u00e1 osoba, mus\u00ed b\u00fdt poji\u0161t\u011bncem zplnomocn\u011bna.<\/p>\n

Co je sou\u010d\u00e1st\u00ed n\u00e1vrhu na l\u00e1ze\u0148skou p\u00e9\u010di?<\/b><\/p>\n

N\u00e1vrh mus\u00ed obsahovat pot\u0159ebn\u00e9 n\u00e1le\u017eitosti, bez nich nelze n\u00e1vrh odeslat<\/b>\u00a0\u2013 z\u00a0n\u00e1vrhu mus\u00ed b\u00fdt patrn\u00e9, co poji\u0161t\u011bnec po\u017eaduje. Je vy\u017eadov\u00e1no doporu\u010den\u00ed, l\u00e9ka\u0159sk\u00e1 zpr\u00e1va, d\u016fle\u017eit\u00e1 anamnestick\u00e1 data, aktu\u00e1ln\u00ed zdravotn\u00ed pot\u00ed\u017ee a onemocn\u011bn\u00ed, v\u00fdsledky laboratorn\u00edch a\u00a0pop\u0159\u00edpad\u011b dal\u0161\u00edch vy\u0161et\u0159en\u00ed, jin\u00e9 informace souvisej\u00edc\u00ed s\u00a0l\u00e1ze\u0148skou p\u00e9\u010d\u00ed atd.<\/p>\n

Doporu\u010den\u00ed je minim\u00e1ln\u011b v\u00a0rozsahu odborn\u00e9ho n\u00e1lezu, pro kter\u00fd se doporu\u010duje l\u00e1ze\u0148sk\u00e1 l\u00e9\u010dba. M\u016f\u017ee b\u00fdt uvedeno p\u0159\u00edmo v\u00a0n\u00e1vrhu na l\u00e1ze\u0148skou p\u00e9\u010di nebo m\u016f\u017ee b\u00fdt p\u0159ilo\u017eeno jako l\u00e9ka\u0159sk\u00e1 zpr\u00e1va.<\/p>\n

Kdo mi m\u016f\u017ee p\u0159edepsat l\u00e1zn\u011b?<\/b><\/p>\n

L\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di m\u016f\u017ee p\u0159edepsat o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159.<\/b>\u00a0T\u00edm m\u016f\u017ee b\u00fdt\u00a0v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159, ambulantn\u00ed l\u00e9ka\u0159 p\u0159\u00edslu\u0161n\u00e9 odbornosti podle dan\u00e9ho onemocn\u011bn\u00ed pacienta<\/b>\u00a0(nap\u0159. ortoped, neurolog, onkolog)\u00a0nebo o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 p\u0159i hospitalizaci pacienta v nemocnici<\/b>\u00a0(ve\u00a0zdravotnick\u00e9m za\u0159\u00edzen\u00ed).<\/p>\n

Dal\u0161\u00ed informace o l\u00e1ze\u0148sk\u00e9 p\u00e9\u010di naleznete na\u00a0<\/i>webu VZP<\/i><\/a>.\u00a0<\/i>VZP hrad\u00ed sv\u00fdm poji\u0161t\u011bnc\u016fm l\u00e1ze\u0148skou l\u00e9\u010debn\u011b rehabilita\u010dn\u00ed p\u00e9\u010di u smluvn\u00edch l\u00e1ze\u0148sk\u00fdch za\u0159\u00edzen\u00ed \u2013 viz\u00a0<\/i>p\u0159ehled<\/i><\/a>.<\/i><\/p>\n

(vzp)<\/strong><\/p>\n

\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

OT\u00c1ZKA: Jak <\/p>\n","protected":false},"author":2,"featured_media":340767,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[88],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2025\/03\/24\/ram-vzp-xxxx.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/340764"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=340764"}],"version-history":[{"count":1,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/340764\/revisions"}],"predecessor-version":[{"id":340765,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/340764\/revisions\/340765"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/340767"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=340764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=340764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=340764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}