From this Tuesday, February 1, 2022, the Health Promotion Entities (EPS) recipients of the 1,169,172 members coming from Koomeva, They must lend the Health services effectively to assigned users.
(See: Ministry of Health begins distribution of Coomeva users to receiving EPSs).
According to the Ministry of Health, they are 14 EPS those that receive affiliates from 23 departments of Colombia.
“They already had time to work with the information that was given to them by this Ministry, which contains the characterization of the population, that is, the special conditions of each of the users assigned to them.”, clarified Iván Mesa, director of Assurance of the Ministry of Health and Social Protection.
(See: Coomeva EPS responds to the liquidation ordered by the Superintendence).
The assigned EPSs contacted Coomeva to obtain more specific details, such as services that were pending coverage, petitions, complaints and claims (PQR), and legal actions such as guardianships, which have not been resolved.
HOW TO CHECK TO WHICH EPS YOU HAVE BEEN ASSIGNED
Through a web page that was enabled by the Ministry of Health (Click here), people transferred to another Company can consult their Destination EPS.
However, the Ministry stated that insurers have the obligation to communicate with their new assigned users, through the different channels that exist. As a recommendation, the portfolio suggested users update your data to facilitate the approach by the destination EPS.
(See: This is how Coomeva users will be distributed to other EPSs).
It should be noted that users have a decision period of 90 days to verify if they are comfortable with the EPS to which they were assigned. If not, they can request a change.
The EPSs that received the most users, in their order, are: New EPS, with 293,117 members, Sura (199,090), health (170,281), Total Health (154,660) and Coosalud (130,338).
263,832 users transferred from the subsidized regime, with Nueva EPS being the insurer with the most users of this modality, specifically 70,693 affiliates.
Regarding possible errors in the transfer, the director Mesa pointed out that there are few cases in which the user was assigned to an EPS that does not have coverage in its territory, this mainly because certain transfers are made by family group (the contributor and their beneficiaries domiciled in different territories).
(See: The ABC of Coomeva’s liquidation and what’s coming for users).
So the user must decide if consider switching to an EPS that operates in more locations in which your family group is domiciled.
BRIEFCASE
