CONSULTANTS TREATING private patients in public hospitals may in future have to pay “a handling fee” to hospitals for submitting invoices on their behalf to health insurers, according to a report.
A value-for-money report, published by the Department of Health yesterday, also says hospitals which do not meet quarterly targets next year for the collection of fees from health insurers for the treatment of private patients in public beds should be penalised financially.
Drawn up by a group representing the Department of Health, the Department of Finance and the HSE, the report comes in the wake of ongoing concern about the time it takes many hospitals to collect money due from the VHI and other insurers.
At the end of last year, some €92.5 million was owed by insurers to HSE hospitals and a further €82.6 million was due to voluntary hospitals at the time.
The report says the HSE should also arrange for public hospitals to “decouple” their own bills for treating private patients from consultants’ invoices for seeing those patients. This would only come into effect following consultation with the insurance companies.
In the meantime the report suggests that starting in 2011 hospitals should only submit the invoices for consultants’ private fees if all necessary forms are fully signed off within 30 days. This is because delays in collecting payment from insurance companies is often blamed on consultants not signing off promptly on invoices.
“Furthermore, where there is no private inpatient accommodation charge due to the hospital, the consultant’s private income claim should be either deprioritised or subject to a handling fee,” the report adds.
The report says the HSE should completely reform the way fees are calculated for treatment of private patients in public hospitals. It recommends hospitals stop charging insurers for only bed days used and instead charge for the type of case treated in that bed. But this new approach is unlikely to begin before 2012 as further advance planning is required and the new system would have to be piloted first.
At present, hospitals charge insurers for bed days used but this approach, according to the report, does not directly relate to the diagnosis of the patient or the cost of the treatment involved. It also provides an incentive to increase the length of the patient’s stay in hospital, and “incentivises the insurers to have complex clients treated in the public system where they are charged by the day and not in relation to the cost of resources consumed, as would be the case in private hospitals”.
The VHI said it saw no basis for separating the bills of hospitals and consultants.
“This would lead to a huge increase in the volumes of claims we process and would increase our internal admin costs,” it said.
Donal Duffy, assistant general secretary of the Irish Hospital Consultants Association, said if the HSE moved to charge consultants a handling fee for looking after invoices “it’s something we would clearly have to discuss with them”.