Saturday 27 December 2014

Health insurers owe €251m to cash-strapped hospitals

Published 02/09/2014 | 02:30

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Roscommon TD Denis Naughten

CASH-STRAPPED public hospitals that are facing in to a winter of cuts are owed more than €251m by private health insurance companies for fee-paying patients.

The figure escalated by €26m between March and June, new figures reveal.

The rise in money owed comes despite claims by hospitals that they have improved the speed at which they are collecting debts. Hospitals also insist that consultants are signing off on forms more quickly.

Denis Naughten, Independent TD for Roscommon, who obtained the information in a parliamentary reply, said the amount of money owed to hospitals was huge.

"Within the next few weeks we will be back to the annual round of belt-tightening by hospitals with services reduced and procedures cancelled. Yet there is a quarter of a billion euro due to them," Mr Naughten (pictured inset) pointed out.

The most recent figures show hospitals are more than €100m in the red this year.

And those with some of the biggest deficits also have some of the biggest private insurance bills due.

Galway city's two major hospitals are owed €22m, while Limerick Regional has €19m due. Cork University Hospital is owed €19m and St James's Hospital is owed €14m.

The figures show that around €102m of the €251m had yet to be invoiced for, delaying the much-needed cash even further.

A spokeswoman for Vhi said it processes eligible claims within five to six days of receiving a fully completed claim form and the necessary supporting documentation.

"As part of our claims cost management, we have a very thorough claims processing system to ensure the medical necessity of a patient's admission to, and ongoing detention in, an acute and appropriate hospital setting," she added.

Aviva, which has a 15pc share of the market, insisted it aimed to pay all eligible claims in a timely manner, ensuring they are settled within 30 days.

A spokeswoman said the settlement may be delayed because the paperwork by hospitals or extra information needed to be verified.

Delays also arise out of the need to check a patient's previous health insurance details. This has increased over the past couple of years as more people change insurers or their level of cover.

The spokeswoman added: "Clearly, an insurer must be satisfied that the claim falls within the level of cover and that the customer has served any waiting period that may apply in the case of pre-existing illnesses or upgrades in cover."

Also there is still no clarity on whether some public beds in areas such as intensive care units can be billed for if occupied by a private patient.

Glohealth said that in its experience a significant proportion of claims were still sitting in the administration department of a hospital and had not yet been received by the insurer.

Laya healthcare said all claims it received were reviewed to ensure sufficient and relevant information was in place.

Irish Independent

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