Through separate press releases, Capresoca EPS and the Casanare Clinic confront each other over the value of the EPS debt with the IPS, observing a great difference in the figures that each of the entities presents and of which they claim to have the respective supports.
While the Casanare Clinic says that the statements made known by Capresoca are “regrettable and defamatory,” the EPS statement reads that the statements made known by the Clinic are “unfounded.”
According to the Casanare Clinic, Capresoca EPS owes a total of $20,581 million pesos, while Capresoca recognizes through a Press Release that the debt is only $9,974 million pesos, that is, there is a difference of more than $10 thousand millions of pesos between the statements presented by each of these entities.
Below, we transcribe the Press Release from the Casanare Clinic, regarding the debt that the EPS Capresoca maintains with this health entity:
COMMUNICATION TO THE PUBLIC OPINION
Regarding the regrettable and defamatory statements, made in an official communication disseminated through the media, by the EPS Capresoca, we allow ourselves to clarify the following:
1. Today, it is public knowledge and as stated in the same statement released by EPS Capresoca itself, the existence of a large debt (a sum greater than that stated in the aforementioned document) that has not yet been settled to our Institution.
2. An executive process is currently being carried out before the Civil Courts of the Yopal Circuit and within it a payment order was issued, by order dated November twenty-three (23), 2023, ordering the retention of the money as a precautionary measure in favor of the Casanare Clinic. For this reason, Capresoca EPS, through its legal representative, presented exceptions on merit, and it will be the Honorable Judge who will determine the pending value of the payments of each of the invoices, object of the execution of the process, in company with the veracity of the statements made before the Court and who will also observe that these are not reckless actions as the current manager of Capresoca infers in bad faith.
3. Regarding alleged portfolio information and “unfiled invoices”, related in the statement released by Capresoca, we announce our ignorance in this regard and reiterate the institutional commitment to clarifying this information.
Likewise, this has been presented on previous occasions, as evidenced in different communications filed in 2023 respectively where it was demonstrated that, despite the financial supports, these are not recognized in portfolio crossings, alluding that they are ‘Invoices’. Not Reported’ by our Institution.
Below, we allow ourselves to disclose the values that, according to our financial-administrative system, and making deductions from the information presented in the statement:
4. Currently, billing and new filings not included in the information previously presented have been generated, for more than $1,500 million pesos, for the services provided to patients affiliated with Capresoca between the months of December 2023 and January 2024.
During 2024, different work table requests have been sent to the EPS Capresoca institutional emails, without receiving a positive response.
5. As allies of this Service Provider Entity for many years, we want to continue working hand in hand for the benefit of the Casanareños, which is why we are fully available to carry out the necessary work tables for the clarification of the information and payment of these resources. .
Finally, and regardless of the economic and/or administrative impact, we reiterate our commitment to continue providing health services to more than 180,000 patients who prefer our care, due to the quality and humanized treatment that characterizes us.
What does Capresoca say?
In turn, the EPS from Casanare recognizes through a Press Release that it does have debts with the Casanare Clinic, but with an astronomical difference in figures that exceeds $10 billion pesos.
According to Capresoca, as of November 30, 2023, the accounts payable to the Casanare Clinic only amount to $9,974 million pesos, that is, the difference between the figures presented by the two entities is more than $10 billion pesos .
Below, we transcribe the Press Release from Capresoca EPS, regarding the debt it maintains with the Casanare Clinic:
COMMUNICATION TO THE PUBLIC OPINION
In response to the different unfounded statements through a statement sent to different media outlets by the Casanare Clinic, regarding the accounts payable that are presented with this IPS. CAPRESOCA EPS, as the Managing Entity of the Health Benefits Plan, is permitted to clarify the following:
At the end of November 30, 2023, accounts payable are presented for NINE BILLION NINE HUNDRED SEVENTY-FOUR MILLION SIX HUNDRED SIXTY-SEVEN THOUSAND SIX HUNDRED THIRTY PESOS MCTE ($9.974.667.630).
Regarding the balance guaranteed by accounts payable, there is a commitment signed before the National Superintendency of Health for a value of TWO BILLION SEVEN HUNDRED FORTY MILLION TWO HUNDRED SIXTY-SEVEN THOUSAND TWO HUNDRED THREE PESOS ($2,740,267,203), this commitment was signed in the month of August 2023 and to date CAPRESOCA EPS has been complying with the established dates and amounts.
The remaining balance payable, that is, the SEVEN THOUSAND TWO HUNDRED THIRTY-FOUR MILLION FOUR HUNDRED THOUSAND FOUR HUNDRED TWENTY-SEVEN PESOS MCTE ($7,234,400,427) are in judicial process included by the IPS, where for the month of December CAPRESOCA presented a payment projection, which was not responded to by the Clinic.
CAPRESOCA EPS, has been available for audit, reconciliation and portfolio updating processes with the IPS, during the 2023 period, multiple meetings were held to reconcile the gloss and update the accounts payable. This is how it is evident that Clínica Casanare presents fluctuations in invoices for the provision of health services in previous years:
Faced with the variations in accounts payable that occur from one month to the next in the portfolio reported by the health services provider, the non-compliance with what is defined in article 130 and its numerals 130.10, 130.11 of Law 1438 of 2011, as well as what is defined in Resolution 6066 of 2016 and article 9 of Law 1797 of 2016.
With the information reported by Clínica Casanare as of November 30, 2023, the balance identification process was carried out, resulting in an account payable balance for SEVEN THOUSAND TWO HUNDRED THIRTY-FOUR MILLION FOUR HUNDRED THOUSAND FOUR HUNDRED TWENTY-SEVEN PESOS MCTE ($7.234.400.427):
Faced with the executive process carried out by the IPS, they seek collection of balances that correspond to objections, tax discounts, invoices in payment agreements signed before the different surveillance and control entities, as well as invoices that are paid and duly legalized. To date, the Casanare Clinic has presented three executive processes, where there is evidence of collection of what is not due and presentation of the same invoices in the different processes.
It is important to inform that CAPRESOCA EPS is available to serve each of the institutions that are part of the network of health service providers and providers, and also invites the public to consult the communication channels provided by the EPS in the event of any concern regarding the provision of services. health and its administrative and financial processes.
This being the case, we will have to wait for the Managers of the two entities to sit down and reconcile the accounts to determine who is right, or else wait for the demands and decisions of third parties that will have to resolve this situation.
Source: news – HOLA Casanare
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