Mr. Tom Byrne:

We have formed an internal team to deal with the health care providers. The issue is expanding.

I will go through individual points. The claims pending have increased from €40 million in December 2012 to €49.5 million in September 2013. This is a more up to date one. Submitted claims awaiting payment have increased from €57 million to €86 million. There is a significant lack of detail provided by insurers to hospitals on the reasons claims are pending and not paid. VHI delay in recognising new consultant appointees means hospital claims related to these consultants are delayed. Insurers are requesting more medical information on low-value claims, resulting in a delay in payment. Some of these claims are not routed through the patient account department, which causes problems. Claims have been returned because consultants used incorrect codes for procedures such as endoscopes and consultants have been notified but the hospitals have not. Insurers will not pay for an orthopaedic procedure unless there is an accompanying medical report and will also contact the patients to ensure it has been done.

We have noticed this slow down in payment back to us. I raise this specifically because of comments that the HSE is not chasing this cash. There is a relatively new request whereby health insurers are seeking patient validation before they will process a claim. Doctors in a certain hospital have told me they must take a photograph of a patient on a bed, even though they might treat that patient in a chair, because the health insurer will not deal with this.