Complaints against health care providers increased by 44% in four months

The number of complaints registered with the National Health Agency by beneficiaries against healthcare providers is increasing and raising concerns. The diagnosis was made by Eliane Medeiros, the agency’s director of inspections, who participated in an event on health regulation in São Paulo on Monday last week (11/9) promoted by the M3BS Advogados office in partnership with IBMEC and the pharmaceutical company Roche.

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The inspection director said the number of primary mediation notices registered over the past six months has risen month on month, rising from 25,000 in April to 36,000 in August, representing a 44% growth. “NIP is an active mediation tool, and we use it to resolve disputes between operators and consumers, but our goal is to have no NIP,” Medeiros said.

Thinking about ways to improve mediation in the relationship between healthcare providers and users, ANS encourages companies themselves to be more independent in managing disputes with customers. The goal is for beneficiaries to search for operators’ SAC and Ombudsman channels before searching for ANS. “The NIP is a pre-procedural phase, but we want to encourage operators to create a pre-NIP phase,” says the manager.

Today, 80% of information requests and complaints at ANS are made by telephone and 20% via the website or through official letters. Medeiros said the agency is trying to standardize channels, especially now with the online channel on gov.br, but it cannot prevent consumers from choosing the path they find simpler. “We had already considered merging our channel with Senacon, but that was not possible due to system differences,” the director said.

Paulo Rebelo, chief director of the ANS, highlighted that regardless of the channel through which the complaint arrives, the agency has a resolution level of about 90% today.

Transparency

At the panel discussion, Mauricio Nunes, director of sector development at ANS, said the agency is committed to giving consumers more power in the health plan selection process. To this end, ANS has opened a process to evaluate providers, called the Hospital Care Quality Monitoring Programme.

The program targets hospitals affiliated with health plans and classified as “general hospitals.” Registrants will share their data and, based on the evaluation, will receive indicators that will be published in January next year. In this year’s edition, 176 hospitals in the country were registered, from referral hospitals to Santas Casas.

“The network is an important element when a consumer chooses to implement a plan. That is why hospitals agreeing to open up their data and publish names is an important step forward,” the director said.

Carolina Ingiza – Reporter in São Paulo, covering justice and politics. He graduated in Journalism from the University of Sao Paulo. Before Gota, he covered politics, economics and business for the Financial Times and Exam magazine. e-mail: [email protected]