Minister seeks time limit for health insurance sign-offs

THE GOVERNMENT is to seek new provisions to have hospital consultants sign off on health insurance forms in a timely manner as part of new talks planned on efficiencies under the Croke Park agreement.

The Minister for Health, Dr James Reilly, told the Dáil last week that there was currently no explicit contractual requirement that medical consultants sign off on health insurance claim forms within an agreed timeframe.

However, he said there were significant amounts due to hospitals from insurance companies as a result of delays in consultants filling in forms in relation to private patients treated in public facilities.

He said that where there were delays in the finalisation of claim forms in respect of private patients treated in public facilities, the receipt of income from insurance companies could be held up, leading to a negative impact on the hospital’s cash flow and financial position. However, he said that in such cases the revenue from the charges was not lost.

“While the HSE and voluntary hospitals recoup considerable sums from private health insurance companies in respect of private and semi-private treatment services provided to their members, lengthy delays often occur between the discharge of patients and the receipt of payment from the companies.

“This has led to an unacceptably high level of debtor days with a significant amount in fees outstanding.

“Some hospitals are much more efficient at collecting this income than others.

“It is intended that more hospitals will achieve the income collection standard of the better performing hospitals, and, as a result, a target of €50 million in accelerated income has been set for 2012.”

Dr Reilly said he had already indicated his intention to have health service management engage with the consultant representative bodies to achieve efficiencies, productivity increases and reform under the Croke Park agreement.

“The timely completion of private patient claim forms is among the issues I wish to see addressed in this context.”

Dr Reilly was responding to a parliamentary question tabled by Kevin Humphreys of the Labour Party who said the delays by consultants in filling in insurance forms had resulted in a loss of €76 million to the State.

The Irish Timesreported last Saturday that an internal HSE audit had found that one public hospital had had to wait for more than five years for consultants to submit some invoices to insurance companies to allow it to be paid.

The audit report, which was completed last March and released yesterday, said the value of insurance claims at the Midland Regional Hospital in Mullingar that were awaiting submission by consultants to health insurance companies stood at €1.6 million towards the end of 2010.