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Discussions are continuing between the HSE and other health insurance market participants and it is hoped that these can also conclude positively and with agreement.
Minister Varadkar said: “I very much welcome the first of these arrangements concluded between the HSE and VHI. There will always be a lag time between insurance claims made and paid. This is true for all forms of insurance. However, the level of outstanding charges relating to unsubmitted claims has been an ongoing issue for the Department and the HSE. This new arrangement, which we hope to finalise very soon with the main operators, will ensure that insured patient charges are submitted and received by public hospitals in a timely manner in the future.”
The agreement commits all parties to introduce electronic claims processing. This will benefit patients, providers and payors by ensuring that claims are submitted, processed and communicated in a timely manner.
This agreement follows discussions with the Insurance Ireland Health Insurance Council, which includes the State’s four main health insurers, and the Minister for Health last year around the management of claims costs. The lack of certainty around public hospital charging was cited as a key driver of costs for all insurers. This agreement is expected to be finalised in January 2016 and will provide greater certainty for insurers of their liability in respect of these charges.