He Ministry of Health of Santa Fe decided to outsource to a private company the collection of services that the hospitals and samcos of the province provide to prepaid clients, members of national and union social works. And in the event that a hospital considers it appropriate, it may also advance in outsourcing collections to insurance companies and occupational risk insurers (ART).
Until now, the collection of these services depended on each hospital and each provincial samco, from where prepaid, national social works, unions, insurance companies and ART were billed directly. This issue became news recently, following a judicial investigation for fraud in the management of these funds by employees ofl Iturraspe Hospital of Santa Fe. At this time, the Boards of Directors of all hospitals and samcos have in their possession a model contract to advance agreements with the company NTB SA, represented by Hugo Miguel Elíasin his capacity as general representative.
Before the AfipHugo Miguel Elías is based in Autonomous City of Buenos Aires, is registered to provide business services, administrative activities and support services. At the moment, the money collected for all these services is then divided as follows: 30% among the employees of each effector, 5% for aid and scholarships, while 65% was intended to cover general expenses of the hospital or samco . Once the new outsourced system begins to operate, the company NTB SA will keep a commission of 15.5% of what it collects. The rest of the money will be distributed as follows: 30% among the employees of each hospital, 5% for aid and scholarships, 49.5% to cover general hospital or samco expenses.
In fact, between April 4 and May 4, NTB SA was already operating on a trial basis in the province. The contracts that are now up for signature by the Boards of Directors establish that “from this trial period it emerged that what was proposed by the contractor adapts to the needs of the hospital, and helps to improve and efficiently recover hospital expenses. and therefore, they agree to enter into this contract for the provision of services in accordance with the following clauses:
-Provide technical and legal assistance to increase hospital billing levels.
-Collaborate in the training of billing staff and other actors involved in the expense recovery process carried out in the hospital.
-Generate the reports and management reports that are required in the form, content and frequency by the administrative and/or health authority of the hospital.
-Provide a computer system for the management of the information necessary to generate billing, with similar characteristics to the platform used until February 2024, which was provided by the National Health Insurance Superintendency.
The term of the contract is one year, although the parties reserve the possibility of suspending it if the commitments made are not met.
Why Santa Fe decides to outsource the collection of hospital and samcos services
Until now, hospitals were in charge of billing and collecting for these services provided to prepaid clients, members of national or union social works, insurance companies and ART. From now on, providers who have the system to do so will be able to continue collecting payments from ART and insurance companies, but the rest of the collection will inevitably be in the hands of the NTB firm. Billing and collection to national and union social works was carried out through an operating system provided by the Health Insurance Superintendence. However, on February 21, the president Javier Milei signed decree 172/24, by which this platform was eliminated and the management model was modified.
In the event that a prepaid, social or union organization did not pay a hospital for the services provided to its members, the Health Insurance Superintendence acted as guarantor, sent the funds owed to the hospital and was in charge of recovering the money. Since this system stopped working – the Ministry sources consulted assured – the collection of the more than 270 hospitals and samcos of Santa Fe collapsed, since the Superintendency guaranteed a flow of funds that no longer arrive. Official estimates indicate that since February of this year, approximately 2,000 million pesos were not collected.
The Province of Santa Fe does not have a centralized billing and collection system for these services, so it is necessary to find a quick response to the drop in collection levels. Officials from the Santa Fe government focused on the analysis of alternative systems that already work in other jurisdictions. In the City of Buenos Aires, for example, there is a State company that is dedicated to billing and collecting for hospital services. However, generating a similar system in Santa Fe would take time since the Legislature would even have to intervene. The province of Córdoba, on the other hand, has outsourced the system. And the company in charge of providing this service is the NTB company. Faced with the urgency generated by the drop in revenue from hospitals and samcos, this model was chosen. At least for the short term, while underlying solutions are analyzed.
