The insurance commissioner is calling for priority for a project that would address one of the biggest frustrations facing the medical community.
Puerto Rico Insurance Commissioner Alexander Adams Vega called for approval this Thursday of House Bill 1459 (PC 1459), which proposes to centralize the accreditation process for health care providers who provide services under the Government Health Plan and private health plans to the island.
The legislation, filed by the administration of Governor Pedro Pierluisi, seeks to amend sections of Act 72-1993, known as the Puerto Rico Health Insurance Administration Act; and add new provisions to Law 194-2011, which is the “Puerto Rico Health Insurance Code” to implement a uniform form and create a unique and cost-effective digital system for collecting the documents necessary to verify the credentials of doctors on the island.
“With the changes proposed in this bill, the process described above, which today can sometimes take six months or more due to excessive bureaucracy, could be shortened to thirty days,” the European commissioner said in written statements. “A unified application form and a centralized digital system (“clearing house”) for collecting in one place the documents available for the Project will allow suppliers to send information only once to one institution and achieve a faster, more efficient and certain result. accredited or re-accredited”.
According to Adams Vega, the project was approved last September by the House of Representatives, and today it was referred to the Senate Health Committee.
In a statement, the Office of the Insurance Commissioner acknowledged that one of the top frustrations expressed by doctors and health care providers is the many barriers that exist today to obtaining a contract with an insurer or health care organization and thus to billing for their services, which provided to the insured population under state or private plans.
One of the main reasons for such dissatisfaction, the press service of the agency notes, is the administrative and bureaucratic overload, due to which doctors and medical professionals have to separately and independently send various, different and comprehensive information to each of the insurers or medical institutions in the process of being able to confirm their accounting data as a preliminary step to being able to enter into a contract with them.
The process, known as accreditation, is not only complex and expensive, but also time-consuming and controversial, causing months of delays because providers cannot serve or earn revenue from policyholders and beneficiaries of health plans, the Commission said.
“Our office supports and reaffirms its commitment to finding solutions to the problems affecting health care providers in Puerto Rico to ensure that patients and policyholders have access to the health care they need. That is why we are asking for House Bill 1459 to pass because we believe it is one of the most advanced steps Puerto Rico needs to take to alleviate the health care crisis that is plaguing us,” Adams Vega added.
The commissioner emphasized that this project favors health workers and, above all, patients, by making more doctors available to provide their services quickly.
Author: First hour
Source: Prime Ahora