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  1. #1
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    Default Doctors and clinics "will not accept" Humano insurance

    If you're insured with Humano you may encounter problems. As usual, the article does not give any background about the dispute that resulted in two medical associations and the private clinics' association announcing they would not be accepting ARS Humano insurance, except for emergency situations, until further notice.

    Check with your broker first, but I would hope that the clinic will give out receipts that can then be reimbursed by the insurer, like the doctors who routinely do not accept insurance.

    https://listindiario.com/la-republic...-sus-afiliados

    https://www.espaciodeprensa.com/2019...la-ars-humano/
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  2. #2
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    probably payment issues. some insurances take a long time to pay the bills and sometimes apply a discount.

  3. #3
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    Not good. Will be monitoring this closely.

  4. #4
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    Quote Originally Posted by dv8 View Post
    probably payment issues. some insurances take a long time to pay the bills and sometimes apply a discount.
    That is exactly the problem, as stated by some docs.
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  5. #5
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    Default Today's DR1 News

    Humano medical insurance suspended
    The Dominican Medical Guild (CMD) together with the Board of the Specialized Medical Societies (Conasomep) and the National Association of Private Clinics (Andeclip) have announced the suspension of consultations and elective procedures for those patients holding ARS Humano medical insurance. There has been no announcement as to the length of time this suspension will last. The boycott is to start on Wednesday, 1 May 2019 when only emergencies and those patients in intensive care will be able to claim under their insurance with Humano.

    The announcement comes as the organizations say they will step up actions in favor of increases in the fees and tariffs for their services. The intention is to extend the boycott to the other around 20 medical insurance providers authorized in the Dominican Republic. CMD president Wilson Roa said that the physicians cannot take it anymore and that according to the CMD regulations they had no choice but to take corrective and disciplinary measures. Roa says that the ARS Humano has not complied with agreements that had been signed in 2017, as reported by Diario Libre.

    ARS Humano is the country’s leading private medical insurance plan with around 33% of the medical insurance plan market, serving around 2.5 million people.
    The other leading medical plans are Palic Salud, Universal and the governmental Senasa that covers those on the subsidized regime.

    The Colegio Médico Dominicano, Consejo de Sociedades Médicas Especilizadas and the Asociación de Clínicas y Hospitales Privados say medical services fees have stagnated despite Social Security Law 87-01 ordering revisions every three years. Adjustments have mostly affected the difference patients pay that can range from RD$250 to RD$1,100 depending on the clinic and the plan. In most cases, the difference is more than they are paid by the medical plan companies.

    The medical organizations also demand that patients maintain free choice in medical services, and that primary care begin with the subsidized regime. The insurance scheme has proven to be highly profitable for the medical plan operators. ARS Humano recently inaugurated a large office building on Av.. John F. Kennedy.

    https://www.diariolibre.com/actualid...les-LB12648065
    http://www.sisalril.gov.do/pdf/leyes/ley_no_87-01.pdf
    https://listindiario.com/la-republic...ntre-afiliados
    https://humano.com.do/Paginas/default.aspx
    https://eldia.com.do/pacientes-a-merced-de-mercaderes/
    https://eldia.com.do/lucha-por-fondo...-sin-servicio/
    https://www.diariolibre.com/actualid...dos-LA12650193
    https://www.diariolibre.com/opinion/...rio-CA12651829

  6. #6
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    Reading about this on other sources and it looks like the Dominican doctors are going to go after all insurance providers to be able to be paid more. Humano, being a big fish, was targeted first.

    Recently my wife underwent a minor surgery at a local clinic. The first question the doctor asked in the operating room was how much he was going to make for the procedure.

  7. #7
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    Quote Originally Posted by windeguy View Post
    Recently my wife underwent a minor surgery at a local clinic. The first question the doctor asked in the operating room was how much he was going to make for the procedure.
    Funny you should say that: Brought to my mind an observation I made a long time ago:

    My father-in-law had a to have a minor surgery in Santiago - his doctors convertible new Mercedes was parked right outside the entrance of the private clinic... No complaints of the work done at all, but my FIL got suddenly a lot poorer, despite being covered by his insurer...

    Meanwhile, our son's German surgeon (in Germany, when we lived there) arrived to a clinic to remove his tonsils, which is a lot more complicated procedure than what they did to my FIL in Santiago... The surgeon arrived and left with his bicycle, wearing an appropriate helmet of course...

  8. #8
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    there is a press conference about this going live on diario libre:
    https://www.diariolibre.com/actualid...ano-OA12654794

  9. #9
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    Quote Originally Posted by josh2203 View Post
    Funny you should say that: Brought to my mind an observation I made a long time ago:

    My father-in-law had a to have a minor surgery in Santiago - his doctors convertible new Mercedes was parked right outside the entrance of the private clinic... No complaints of the work done at all, but my FIL got suddenly a lot poorer, despite being covered by his insurer...

    Meanwhile, our son's German surgeon (in Germany, when we lived there) arrived to a clinic to remove his tonsils, which is a lot more complicated procedure than what they did to my FIL in Santiago... The surgeon arrived and left with his bicycle, wearing an appropriate helmet of course...
    LOL liked the helmet part

  10. #10
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    Quote Originally Posted by josh2203 View Post
    Funny you should say that: Brought to my mind an observation I made a long time ago:

    My father-in-law had a to have a minor surgery in Santiago - his doctors convertible new Mercedes was parked right outside the entrance of the private clinic... No complaints of the work done at all, but my FIL got suddenly a lot poorer, despite being covered by his insurer...

    Meanwhile, our son's German surgeon (in Germany, when we lived there) arrived to a clinic to remove his tonsils, which is a lot more complicated procedure than what they did to my FIL in Santiago... The surgeon arrived and left with his bicycle, wearing an appropriate helmet of course...
    I may be alone, but I WANT my doc to be so successful and good at what he does he has a fleet of Mercedes.

    Keep in mind a good number of the better docs in the DR were born into wealth.
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