Health service providers are reminded that a resolution prohibits clinics from demanding obligatory payment or guarantee before a patient is admitted to a private clinic. Clinics cannot require guarantees or deposits according to the office of the Superintendent of Health and Work-related Risks (Sisalril). Persons or families that face this situation are urged to get in contact with the Information and Defense of the Affiliate Agency (DIDA). They should also get in touch with their health insurance provider.
According to Sisalril, as long as the patient’s insurance covers the procedure, no pre-payment of any kind is allowed. This policy has been in effect since 2008.
The issue comes up often when a patient is treated in the Emergency Room and the clinic decides that he/she needs to be hospitalized. Payments or guarantees of up to RD$100,000 are not uncommon.
Since this often occurs at advanced hours of the night, a response from an HMO or Sisalril is very difficult to obtain.
On the other hand, the spokesperson for the Association of Private Clinics and Hospitals (Andeclip), Rafael Mena noted that the deposit request is made to guarantee the financial risks associated with a hospitalized patient. He also told reporters that the clinics were not violating any law by requiring a deposit for the hospitalization of a patient, and that this is necessary because the authorities are not fulfilling their obligations under the Social Security Law.
Listin Diario reports that the deposit is requested to about 10% of the patients and these are mostly people who are uninsured or the clinic does not have a contract with the insurance company. The newspaper reporters ascertained that the deposit is set depending on the costs estimated by the clinic when the hospitalization request is made.
Mena of Andeclip says the clinics are only obliged to stabilize the patient arriving to the emergency room.
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Listin Diario
14 February 2022