The National Superintendent of Health, Giovanny Rubiano García, ordered the new EPS to implement an intensive legalization plan with the providers, after the findings presented by the Comptroller General of the Republic on the administrative and financial situation of the entity.
As explained, what in the report is called as advances really corresponds to payments for services already provided that have not been accused of specific invoices. Rubiano said that these inconsistencies had already been identified by the Supersalud and that, since August, when the precautionary measure was filed to the EPS, A work plan was launched to correct failures.
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“New EPS has been doing is a big effort to pay the providers throughout the national territory, not only in cities. What did not do in a timely manner was to clarify, before each payment made, to which invoices the provider had to impute the value paid”He said.
The official said that, in accordance with current regulations, if the payer does not define which invoice to apply the payment, the provider must do it. In the event that neither of them establishes it, the regulations determine that the fertilizer applies to the oldest invoice accepted.
“In the Comptroller’s report, all paid money that has not yet said what invoice should be applied in their accounting records and also new EPS in their own accounting are called advances. However, it is wrong to use the term in advance, since they really correspond to services already provided”Rubiano explained.
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The resources correspond to services already provided, but without imputation to specific invoices, according to Superintendent Giovanny Rubiano.
Courtesy Ins
In that sense, the instruction to the entity is to sign minutes with each provider to define the imputation of the payments already made and thus eliminate what the Superintendent called as “figure of the false advance”.
“The order that I have given to the new intervening manager, Gloria Polanía, who within a few weeks must have finished the round with providers throughout the national territory to define the application of payments received to specific invoices”He added.
Rubiano clarified that there is only a small proportion of contracts that can be considered true advances, corresponding to stock -type agreements with some low complexity IPS. In these cases, Providers must legalize the services provided or return the resources that have not been executed.
The Superintendent also questioned that the Comptroller’s report has not taken into account the technological limitations of the EPS. “The Comptroller is forgotten in its report that the EPS maintained flaws in the integrity of the information systems, making it difficult to carry out transverse monitoring of the different processes and delays, especially in the processing of medical accounts and subsequent accounting”He said.
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According to the Supersalud, during the intervention, Nueva EPS implemented the facttramed system to strengthen medical accounts processing and improve financial transparency.
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He added that during the intervention the entity was recommended to implement robust information systems that allow the accounting recognition of invoices and the reduction of repayments. Among the measures adopted, he highlighted the use of the facttramed platform, which seeks to reflect more precisely the financial reality of the EPS.
Rubian insisted that the intervention to the new EPS does not constitute an arbitrary decision, but a mechanism to safeguard system resources. “Intervention is not a capricious mechanism, quite the opposite, it seeks to guarantee good destiny and efficient use of existing resources”He said.
In this context, the Superintendency also requested the hiring of a medical audits service with greater capacity and constant interaction with the providers, supported by technological developments that already use different entities of the sector. The objective is to strengthen the validation processes and ensure the opportunity in attention to affiliates.
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Diana K. Rodríguez T.
Portfolio journalist
