Consultants delay hospital pay by insurers

Over €70m owed to public hospitals is being held up by consultant doctors who have failed to sign off on private health insurance claim forms.

Consultants delay hospital pay by insurers

The money is owed to acute hospitals for treatment received by private patients in public facilities.

Under current rules, private health insurers will not reimburse public hospitals for the treatment and accommodation of patients until consultants sign off on the overall claim.

The most recent figures show that claims with a value of €70,664,939 are currently awaiting action by hospital consultants, without which no money can be recouped.

Earlier this week, it was revealed that acute hospitals are facing the prospect of imposing drastic service cuts as they struggle with a combined budget deficit of €63m for the first three months of the year.

Galway University Hospitals has the highest value of claims pending sign-off by consultants, at €7,890,244, followed by University Hospital Limerick at €6,286,498. Dublin’s St James’ Hospital has claims worth €5,708,962 awaiting action by consultants, while Cork University Hospital also ranks amongst the highest claimants at €5,211,210.

The figures were released by the Department of Health in response to a parliamentary question by Galway West TD Brian Walsh.

In a letter to Mr Walsh, Health Minister James Reilly stated that the amounts owed by private insurance companies is monitored on a continual basis and is the subject of ongoing discussions between the HSE and private insurers.

“In recent years, the HSE has introduced a number of initiatives to improve the claims collection process and facilitate faster submission of claims to accelerate income collection within the public hospital system,” said Dr Reilly..

“In particular, the HSE has tasked hospitals with bringing down the value of claims awaiting consultant action and targeting the highest value claims.

“The HSE has agreed proposals with the two consultant representative bodies committing consultants to expeditious processing and signing of claims for submission to the private insurers.”

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