Iapos established the Service for the Reception and Management of Claims for Abusive Practices so that the beneficiaries of the social work can complain about situations in which the providers do not respect the commitments made, such as the requirement to collect a bonus.
In this way, members can make the claim in person at the Institute’s offices, through the IAPOS Call Center – 0800 444 4276 -, or online by entering the website www.iapossantafe.gob.ar/reclamos (with reservation of identity of the affiliate).
The data collected by the Claims Management Center will allow the social work evaluate the behavior of providers and adopt applicable corrective measures in accordance with the “Sanctioning Procedure and Regime” stipulated in the agreements with the entities.
In this regard, the director of Iapos, Oscar Broggimaintained that “Charging extra is not allowed in the province of Santa Fe, because there is a law that prohibits it. Given this, our affiliates can report anonymously through the Iapos website. We inform these doctors, we initiate a summary, and they are sanctioned by removing them from the registry from one month to permanently according to the seriousness of the situation. “Last year there were 400 complaints, of which 200 were verified.”
In addition, Broggi pointed out that “during this year three large tariff agreements were made. at the beginning of the year, in March, and in August. The update that corresponds to the last semester – from August to December – represents an increase that in the fee today in September it is $2,500, in October it is $3,000 and in December it will be $3,800.
Quality coverage without extra requirements
Iapos members access the benefits provided by the social work with the confidence of having quality coverage that includes timely care, adequate treatment and the absence of extra requirements on the part of the providers, which mean discrimination in undue attention or charges, without respecting the agreements that link them with social work.
In the province of Santa Fe, Law No. 13731 of 2017 prohibits health professionals from charging above the agreed fees with the different social works and prepaid services, and grants the Ombudsman the power to carry out the control and subsequent actions.
In relation to the updating of tariffs and professional fees, the provincial social work agrees on the tariff values of the benefits with the Medical Unions and the Associations of Clinics and Sanatoriums of each department of the province.
In the month of August, the new benefit and rate tables were agreed with each of them until December of this year. The updating clauses are also maintained, similar to the parity clauses for provincial workers. Within this framework, dialogue is maintained with the different unions to analyze the evolution of values and their adaptation.
On this point, the director of Iapos assured that “we transferred the transfer of the resources that enter the social work by equal increase to the providers. We gave the professional fee an increase above what we give to clinics and sanatoriums, because We saw that last year we had fallen behind. We understand that there is a national situation, that there are some lenders or financiers who are not paying them in a timely manner, but at Iapos we pay immediately.”
“At the beginning of the year the consultation was $1,460, and we are reaching $3,800 at the end of the year, the increase was higher than the provincial parity. We make efforts and we do not lose the dialogue,” noted Broggi.
