36.4 C
San Juan
viernes, diciembre 9, 2022

Las aseguradoras dicen que el sábado es demasiado pronto para cumplir con los objetivos de la Casa Blanca en las pruebas rápidas.


A partir del sábado, las nuevas reglas federales requerirán que las aseguradoras privadas cubran las pruebas de coronavirus en el hogar que los estadounidenses compran en farmacias y otras tiendas. El nuevo sistema podría, en teoría, permitir que millones de personas recogieran pruebas en miles de lugares sin gastar dinero.

Es probable que la realidad, al menos a corto plazo, sea más complicada: algunas aseguradoras dicen que probablemente tomará semanas configurar completamente el sistema que prevé la Casa Blanca.

El nuevo proceso será difícil, dicen las aseguradoras, porque las pruebas de coronavirus de venta libre son diferentes de las visitas al médico y las estadías en el hospital que normalmente cubren.

Las pruebas actualmente no tienen el tipo de códigos de facturación que usan las aseguradoras para procesar reclamos. Los planes de salud rara vez procesan recibos minoristas; en cambio, han creado sistemas para reclamos digitales con formatos preestablecidos y códigos de facturación establecidos desde hace mucho tiempo.

Debido a esto, algunas aseguradoras planean administrar los reclamos de prueba rápida manualmente al principio.

“Esto es llevar las cosas a los viejos tiempos, donde una persona tira todos estos papeles en una caja de zapatos y, finalmente, los mete en un sobre y lo envía a una aseguradora de salud para que los descifre”, dijo Ceci Connolly. , el director ejecutivo de Alliance of Community Health Plans, que representa a las aseguradoras más pequeñas sin fines de lucro.



Fuente:nytimes.com/

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