Tuesday, May 30, 2023

ASES warns insurers they must continue to pay dentists’ fees for COVID-19

Executive director of Puerto Rico Health Insurance Administration (ASES), Edna Marin Ramos warned this tuesday insurance companies who contracts with key plan What continue to pay dentists special rate established for costs and expenses relating to Epidemic Of COVID-19,

Marin Ramos’ statement came as insurers began sending notices to service providers stating that the special rate of $14.51 per visit, corresponding to the special code, would no longer be paid following the declaration of the end of the state of emergency due to the pandemic. For disease caused by the coronavirus SARS-CoV-2.

“We learned that Vital Plan’s insurers issued communications to provider networks, specifically dentists in Puerto Rico,” picked up in an interview with Marin new day,

“ASES has not issued any directives contrary to what has been approved so far and none of the communications issued by insurers to dentists in Puerto Rico have been authorized by ASES,” insisted the executive director.

Marin said today ASES will issue an official communication to insurers and warned that they must “continue to cover the so-called “COVID fee” (rate) for all critical patients.” Vital’s insurance companies are MMM Multihealth, First Medical, Plan De Salud Menonita, and Triple-S.

Governor Pedro Pierluisi Last Wednesday, Executive Order 2023-012 was signed, declaring that the state of emergency, since the beginning of 2020 due to the pandemic, has ended. The new executive order came after the President of the United States, Joe Biden, also announced the end of the emergency period of the epidemic. Similarly, the World Health Organization (WHO) reported on 5 May that COVID-19 no longer qualified as an emergency.

However, the culmination of an emergency period does not end the disease, Dr. Raul Damaso Ortiz Escalera President of the College of Dental Surgeons of Puerto Rico.

“The College of Dental Surgeons, as an institution, supports maintaining the code (of fees for COVID-19)”, The doctor pointed. “Prices of all security items shot up to levels never seen before. Gloves used to be less than three cents, now they’re eight to ten cents. Protecting ourselves, as we protected ourselves in the past, has cost us twice as much after COVID-19.” Story.

Ortiz Escalera pointed out that this situation, which arose immediately after the end of the emergency declaration, also affects the private sector of insurers. At least two insurance companies – Triple-S and Delta Dental of Puerto Rico – have written to dentists about the termination of COVID-19 fee payments tied to Code D1999 to cover payment for personal protective equipment in dental offices notified.

“It is a matter of days for others to come (communications from other insurers),” the president said. The dental surgeon said the fee associated with code D1999 is $34.

In relation to private insurers, according to the president of the association, after the declaration of the end of the emergency, the commissioner office of the commissioner of insurance, Alexander Adams Certified the elimination of the fee, but not the code.

“What the insurance commissioner certifies is the elimination of the rate, but mentions that he keeps the code in force,” Held. The Insurance Commissioner’s call was for the parties to negotiate a new figure, by eliminating the rate and keeping the code.

“It is our hope that it will be so. From experience, insurers never sit down to negotiate, they decide and inform us about it,” Ortiz Escalera lamented.

The President pointed out that this determination is a threat against the safety of patients.

“We are recommending that co-workers continue billing the plan for the same things they were billing until that recommendation from the insurance commissioner is met,” he said of those providing services in Puerto Rico. Addressing the dentists said.

Nation World News Desk
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