In the first five months of the year, the plan now managed by the NotreDame Group received 30 complaints from the ANS.
Author: Ana Carolina Leal
May 29, 2022 at 8:31 am • Last updated May 29, 2022 at 8:35 am
The long wait for medical care that is common in the public health network has also affected users of the São Lucas plan, Americana. In May alone, he contacted at least 15 patients at LIBERAL, complaining of delays in seeing a doctor and taking medication. In the first five months of the year, the plan now managed by the NotreDame Group received 30 complaints registered with the ANS (National Agency for Complementary Health).
Accountant Ana Carolina Leal, 37, was in hospital in São Lucas this week to take her 19-year-old daughter, who had a fever, shortness of breath and severe headaches. He said he got the password at 6:23 p.m. At 8:15 p.m., the unit left the unit and Dr. Waldemar Tebaldi.
“It’s very complicated there. And there was no one to satisfy, no one to enlighten. I filed a complaint with the ombudsman. At the town hall, my daughter Covid was seen and tested for an hour, ”he said.
A 42-year-old salesman who went to the São Lucas hospital this week for a medical appointment with his father said he arrived at the unit at 3.50pm and was only seen around 10pm.
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“My father is 69 years old and I took him because he had a lot of body aches and coughs. It took him almost an hour to get to the hospital. Hours passed and no one called. At around 7.20pm, the doctors closed the doors of the office and did not call again, ”he said.
According to the vendor, patients waiting for care began to complain from 2 p.m. And at the reception, no one reported anything.
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“Then we found out that the shift had changed and that the system, according to a doctor, was not working and that he could not attend or fill out the medical form manually because the hospital administration did not allow it,” he explained.
Consultations would not return until around 22:00. “The doctor said it could be dengue, but because he was shaking in front of so many patients, I had doubts about the diagnosis and the next day I took my father to City Hall. He tested positive for Covid.
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According to Cristiano de Oliveira Domingos, the chairman of the Medical Law Committee of the Brazilian Bar Association (OAB), Americana, operators must ensure immediate attention in cases of urgency and emergency.
Domingos says users who are not properly cared for should ask for explanations on their health plans through contacts that contain operator mediation protocols and complaints.
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If unsuccessful, it drives, the user must file a complaint with the ANS. “The agency ensures that all complaints are investigated and that the user with the protocol number is able to follow the progress
your complaint ”.
The ANS states that claims are automatically sent to the responsible operators, who will have a period of five working days to resolve the beneficiary’s problem in cases where coverage is not guaranteed and a period of up to 10 working days in cases of no request for assistance. If the problem is not resolved, an administrative procedure may be opened, which may impose a fine on the operator.
In a statement, the board of the Hospital São Lucas de Americana reports that the computerized management system of the unit was replaced earlier this month to increase the quality and safety of care.
The health unit also clarified that in order to reduce the impact of the change, it had started training and enrollment in the group 60 days earlier. However, despite all these measures and the high demand due to the autumn season and the ongoing dengue epidemic in the city, the hospital saw a significant increase in waiting lines.
“We are prioritizing the care of the most serious cases and all those in charge are committed to normalizing care as soon as possible,” the statement concluded.