Public Health
publicado em 07/05/2013 às 11h39:00
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Starting today, plans have to justify negative coverage written

 
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Andrew Long, CEO of the National Health Agency (ANS)
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Andrew Long, CEO of the National Health Agency (ANS)

The National Health Agency (ANS) published in the Official Gazette, on Tuesday (6), normative resolution, which requires health insurance providers to justify in writing to the beneficiaries when there is refusal of care. The health insurance will have 60 days to fit the new rules.

A written response will be given by mail or by electronic means, as choosing the beneficiary of the plan, within 48 hours of the request. The information shall be transmitted to patients requesting in clear language indicating the contractual or legal provision to justify the reason for the refusal.

"When a beneficiary makes a request for examinations, consultations or surgeries, the operator has deadlines to release or deny that request, giving the relevant information in case of rejection, which can now also be requested in writing," adds Andrew Long, director president of ANS.

If the operator fails to provide written reasons for the denial of coverage provided by law, whenever requested by the beneficiary will pay a fine of £ 30,000. The fine for undue negative coverage in cases of emergency rooms is $ 100,000.

Source: Isaude.net
   Palavras-chave:   National Health Agency    NSA    Official Gazette    Andrew Long    Normative resolution   
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