Home South AmericaColombia Supersalud intervenes EPS from 13 territories due to user complaints

Supersalud intervenes EPS from 13 territories due to user complaints

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Supersalud intervenes EPS from 13 territories due to user complaints

In the last few hours, the National Health Superintendency showed the progress of its intervention in 13 territories that had the highest levels of user vulnerability and non-compliance in payments to providers by resource management entities (EPS).

(Read: Is it possible to eliminate EPS in Colombia? The scenarios that exist).

Three months after initiating the strategy, se action plans have been carried out that link 22 EPS in the contributory, subsidized and indigenous regimes so that they provide answers and solutions to the needs of their affiliates, and to establish payment agreements with the institutions that provide services in the territories.

We have reached these territories where extreme criticality predominated for
enforce our two primary lines of action: guarantee the right
to the health of citizens and protect public health resources
”, assured the
National Superintendent of Health, Ulahí Beltrán López.

So far there have been days of intervention in Casanare,
Guaviare, Antioquia, Bogotá, Chocó, Valle del Cauca, Santander, Vaupés, Vichada, Risaralda, Bolívar, Meta and Putumayo.

(In addition: Computer attack on Sanitas did not compromise user information).

This implies a coverage in 415 municipalities of the country in which its inhabitants have filed around 644,590 petitions, complaints, claims and denunciations in the period from January to October 2022. This is 62% of all the requests received in the country.

Accordingly, Supersalud has begun to review aspects such as untimely delivery of medications, delay in referral and counter-referral, delays in the authorization of services, untimely scheduling of outpatient services, network failures and delays in scheduling specialized appointments.

To date, 8 Territorial Action Plans have been approved, 4 are in follow-up and one has already ended. The idea is that these plans lead to prompt and effective solutions for the identified problems.

(Keep reading: Soat Discount: ABC to find out if it applies to you and what it covers).

Some of the entities that participated are Nueva EPS, Sanitas, Sura, Famisanar, Total Health, Compensar, Capital Salud, Salud Mía and others.

BRIEFCASE

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