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Saneamiento de recobros NO POS ante Fosyga
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El Decreto 1865 de 2012 tiene por objeto reglamentar el saneamiento de cuentas por recobros cuando se presenten divergencias recurrentes generadas por las glosas aplicadas en la auditoria integral a los recobros presentados por las entidades recobrantes (EPS) ante el Fosyga, asi como disponer de la aplicacion, por unica vez, de dicho procedimiento para aquellos recobros que a la entrada en vigencia del Decreto Ley 019 de 2012 (antitramites), hubieren surtido la auditoria integral, culminando con estado glosado, por considerar que la tecnologia incluidad se encontraba incluida en el Plan Obligatorio de Salud POS.
Entiendase por divergencias recurrentes, segun el Decreto 1865 de 2012, las diferencias conceptuales entre mas de una entidad recobrante y el MInisterio de Salud – Fosyga, respecto de las glosas que por cualquier causal hayan sido aplicadas a las solicitudes de recobro en mas de un periodo de radicacion.
Las EPS que se acojan a esta revision, autorizan que los recursos aprobados, seran girados directamente a las IPS habilitadas.
El tiempo que tiene el Ministerio de Salud y el Fosyga para revisar las divergencias presentadas por las EPS es de hasta tres (3) meses contados a partir del momento de la radiacion.
Descargue: Decreto 1865 de 2012 – Saneamiento recobros NO POS ante el Fosyga.
Este artículo tiene documentos adjuntos que podrá descargar para ampliar su información:
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