Written answers

Tuesday, 7 May 2013

Department of Health

Health Insurance Claims

Photo of Andrew DoyleAndrew Doyle (Wicklow, Fine Gael)
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373. To ask the Minister for Health if he is considering reducing payments made to doctors if they fail to file private health insurance paperwork on time in view of the fact that it costs the State €61 million per year; and if he will make a statement on the matter. [21094/13]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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The Health Service Executive is continuing a drive to reduce the time taken to submit claims to private health insurance companies. It should be noted that the non timely completion of paperwork does not cost the HSE €61m, as the money does get paid. However, it is acknowledged that there is a timing issue and that is what the HSE is focused on. The number of days taken for consultants to complete forms has reduced from an average of 62 days in 2010 to an average of 44 days in 2012 representing an improvement of 29%. The HSE target is 14 working days for consultant sign-off. The percentage of overall insurance debt that is within HSE / Consultant control has decreased from 61% in 2010 to 47% in 2012.

The HSE is focused on:

- Continued roll-out of the Electronic Claims Management System in its hospitals. Twelve sites are currently using the electronic claims system representing 51% of overall national claims. Over 80% of claims will be electronic by the end of Dec' 13. This system will address the deficiencies of the paper based process and will also ensure that standardised work practices are implemented across hospitals.

- Obtaining compliance with the commitment set out in Section 5 (vii) (a) of the document Consultants - Implementing the Public Service Agreement that was issued by the Labour Relations Commission on the 17Sept 2012. This required “a commitment from all consultants to fully complete and sign private insurance forms within 14 days of receipt of all relevant documentation”.

- Intense focus by Acute Hospital Management on improving the collection of this key source of funding.

Significant progress has been made in the last two to three years and there is a plan in place to significantly improve the process further. This will encompass hospital processing and consultant sign-off. There remains a significant challenge in improving the speed of payments from insurers and this is something which the HSE is engaging on with both the insurers and the Department of Health.

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