Hospital consultants who fail to sign off private health insurance claims promptly are being “actively followed” by Saolta University Health Care Group’s finance department to ensure the cash strapped health service is not missing out on millions of euros in vital income.
The Saolta Group comprises three local hospitals - UHG, Merlin Park, and Portiuncula - as well as Mayo General, Letterkenny, Roscommon and Sligo Regional Hospitals.
Claims worth €18.46m have not been submitted because they are awaiting consultants’ action, a meeting of the HSE West’s regional health forum was told recently.
According to the Saolta Group’s insured debt report as of July 31 some €18.31m in insurance claims had been submitted to private health insurers and the hospital group was awaiting their response.
A total of €16.24m in claims had been submitted but was under query with the insurer. Some €2.41m had not been submitted because it was awaiting other action and €2.87m in claims was ready for submission.
The information came in a written reply to a question posed by forum member, Ennis Fianna Fail councillor Tom McNamara who asked for an update on the money outstanding to the hospital groups from private health insurance companies. He wanted to know how much of this “related to claims under preparation in hospitals, what work is being done as regards getting hospitals to submit these invoices in a timely manner and what action is being taken to tackle delays in submitting the paperwork”.
The meeting was told the HSE is currently negotiating with the private health insurance companies and it is expected that significant progress on the outstanding debt will materialise from these discussions.
It is also anticipated that amounts currently outstanding due to legislative change in 2014 will be resolved.
“All hospitals are engaged proactively in reducing debt and where possible additional resources have been allocated in this process. Additional resources have also been sourced to assist consultants in completing their volume of work.”
The substantial amount of money owed to local hospitals because of the delay by some consultants in signing off private health insurance claims has been raised at numerous HSE West regional health forum meetings.
Outspoken Fine Gael councillor, former mayor and forum member Padraig Conneely has been particularly vocal on the issue. He accused “well paid consultants” of not “co-operating” by being tardy in signing off the documentation required to complete the claims.
At one meeting he said he had been raising the issue “year in, year out” and it was “disappointing” that the situation was continuing. He called for the offenders to be “named and shamed” and vowed to continue to criticise the consultants responsible. Cllr Conneelly was absent from the most recent forum meeting.
