Santo Domingo.- The director of National Health Insurance (Senasa), Edward Guzmanreaffirmed the commitment of the institution of maintain the provision of health services to its members and continue improving the payment times to providers.
During a courtesy visit to the newspaper editor The Day, José Monegro, Guzmán explained that Senasa maintains as its main goal pay lenders in an average of 60 daysa period that was even reduced to 55 days in Decemberand that will continue to decrease as much as possible.
“My main commitment is that we can pay within 60 days. Anything I can improve to pay faster is profit,” he said.
Payment flow and relationship with providers
The official explained that, although the payment cycle is 60 days, large health centers have a constant monthly flow that allows them to operate without major difficulties. However, he acknowledged that smaller providers may feel the impact when they don’t have that continuous flow.
In that sense, he highlighted the Senasa’s permanent rapprochement with clinics, doctors and unionsincluding the recent reaffirmation of commitments with the National Association of Private Clinics and Hospitals (Andeclip)to ensure the continuity of service to members.
“The trust of the providers with Senasa remains normal. The flow of payments remains normal,” he assured.
Senasa, the ARS with the greatest coverage and network of providers
Guzmán highlighted that Senasa concentrates almost 40% of the population in the contributory regimewith 1.8 million membersfar surpassing the second ARS on the market.
Furthermore, he stressed that Senasa is the only ARS that offers greater coverage at high costdoubling the amount established by Social Security with a cstandard overture up to 1 million pesos, while in Senasa is from up to 2 million pesos.
Another added value is that Senasa has the largest network of providers contracted nationwidebetween medical centers and independent professionals, which facilitates access to health services throughout the country.
Resource optimization and price negotiation
The director of Senasa explained that the institution acts as demand funderusing their purchasing power to negotiate prices down in medicines, materials and services, which contributes to the sustainability of the system.
Likewise, he reported that Senasa works in the development of its own platform for pharmaceutical managementwith the aim of directly assuming this process and reducing dependence on intermediaries such as Farmacard.
He indicated that of the 17 ARS that exist, only one has developed its own system, but Senasa is moving in that direction.
Concern about the member experience
Guzmán was emphatic in pointing out that his greatest concern is to avoid any deterioration in service quality that the member may receive, especially in waiting times.
“When a member of another ARS lasts 10 or 15 minutes and one of Senasa lasts 40, that gives impotence. That is unacceptable,” he said.
He remembered that Senasa’s reason for being is the affiliateand that all institutional management is aimed at guaranteeing dignified and timely care.
Subsidized regime, the most stable
Finally, he clarified that the subsidized regime does not present operational or financial problemsand which is currently the most stable within Senasa. In contrast, the contributory regime concentrates the greatest financial burden, although mechanisms such as per capita differentiated They allow the system to balance.
Guzmán also highlighted the social role of Senasa in guaranteeing coverage to pensionershigh accident rate affiliates and care for traffic accidentsboth in the contributory and subsidized regimes.
“Senasa fulfills and assumes its social role. There are important challenges, but we will overcome them without any type of problem,” he said.
Systematization
—1— Platform
Senasa is working on the development of its own platform for pharmaceutical management.
—2— Dependency
Its purpose is to directly assume this process and reduce dependence on intermediaries such as Farmacard.
—3— Own
Only one of the 17 insurers has it.
