Regarding the case of Nini Dayana Cisneros, who requests transfer to a highly complex medical center to undergo surgery after suffering a serious traffic accident in Orocué, Capresoca explained the situation of the patient whose relative chained herself at the entrance of the Hospital to ask for help.
The entity clarified that, when a person is injured in a traffic accident, the IPS provider of the emergency service in which they are treated, must give them all the necessary attention to achieve their stability, treatment and rehabilitation of their sequelae and pathologies. generated as a consequence of the accident; This care is part of the coverage of the SOAT Compulsory Traffic Accident Insurance and has a ceiling or limit of 800 current legal daily minimum wages, equivalent to $30,933,000.
However, if the victim who suffers a traffic accident and the vehicle involved did not have a SOAT contract, they must also be treated under ADRES.
Therefore, the current coverage of the patient, Niny Dayhanna Cisneros Alonso, is in charge of her contracted SOAT insurance, which is PREVISORA SA COMPAÑÍA DE SEGUROS, since up to now a value of $13,749,366 has been consumed in her hospital care. .
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Case of Shaira Rocio
Regarding the case of the minor Shaira Rocío López Hernández, who was admitted to the emergency service of the Orinoquia Regional Hospital on June 12 of this year; At the discretion of the pediatric specialist, on June 24, he issues a referral order to an institution with availability of the Intermediate Care Unit service.
Based on said request, this Benefit Plan Administrative Entity (EAPB) began the corresponding procedures in order to guarantee the service required by the user, receiving on June 26, 2023, acceptance of the clinical case by IPS Gyomedical in the city of Yopal, an institution that is part of our service network.
The girl’s mother did not accept the transfer
In response to the acceptance of the minor, telephone communication is established with Mrs. Jessica Hernández Macías, mother of the patient, who states that she does not accept a transfer to the IPS GYOMEDICAL, submitting a letter of withdrawal on June 26, which prevents her transfer and the institution receiving proceeds to cancel the available bed.
Due to this, a multidisciplinary team from Capresoca EPS, contacted the mother of the minor, explaining the risks of not accepting the transfer, expressing understanding and once again requesting that it be presented to Gyomedical IPS, therefore, the presentation begins again. from the clinical case to the service network.
Thus, the minor is being presented in institutions such as Gyomedical, Hospital la misericordia, Integrated Sub-Network of Health Services (Kennedy Hospital), Cardiovascular Foundation of Cundinamarca, Society of Pediatric Surgeons in Barranquilla, Cardiovascular Foundation of Colombia , Villavicencio Departmental Hospital, with notification to the reference and counter-referral regulatory center of the department of Casanare – CRUE and Bogotá, pending prompt acceptance.
Source: Capresoca EPS