Making sure your paperwork is all in order for your healthcare abroad is important.
Healthcare Abroad will assist and guide you through the process to make sure everything is in order for the HSE to approve your surgery now.
There are rules about accessing care under the cross border directive and the HSE will need those rules to be followed.
The case below is from the latest Ombudsman’s Report for 2021 just published.
The Ombudsman in Ireland report examined a cross border healthcare case involving a young woman who needed important medical treatment.
This lady did not use the services of Healthcare Abroad.
The treatment was available in another country and the cost of treatment was eligible for reimbursement by the HSE.
The woman’s mother appealed to the HSE when her daughter’s application under the scheme was refused
In his report, the Ombudsman noted that the patient is required to have an initial outpatient consultation in the country they intend to be treated in and this must have taken place on a date prior to treatment.
The HSE had refused the application, as it said there was no evidence of an initial consultation.
It is essential to have proof of your initial consultation.
It also said there were discrepancies with the invoices provided and insufficient proof of payment.
Make sure all your invoices are correct and in order.
In relation to the evidence of a prior outpatient consultation, the HSE said the letter from the clinic was unsigned, undated and unaddressed.
All documents must be signed, dated and addressed otherwise they are not legal documents.
But when the Ombudsman examined it, while the letter was unsigned, it was dated and had the address of the clinic.
The Ombudsman believed that there was sufficient evidence of the prior outpatient consultation.
Without the correct documentation it can be very hard to prove that you have done everything correctly – Healthcare Abroad ensures all your documentation is legally acceptable before submitting to the HSE.
The Ombudsman did find discrepancies with invoices provided by the clinic, including gross figures being provided, which included accommodation and other costs not associated with the treatment.
More often than not discrepancies will not be accepted after the application has been submitted.
He contacted the clinic and it provided figures sufficient to clarify the treatment for the HSE to proceed.
There was a further issue regarding the proof of payment.
Proof of payment is essential in all applications.
The woman had paid a deposit for treatment electronically and the balance in cash.
Understandably cash is not an acceptable form of payment in most circumstances.
The Ombudsman was satisfied with proof of the loan and a final invoice was marked paid in full.
The HSE was asked by the Ombudsman to review its decision.
It agreed to the application and the HSE reimbursed the woman the treatment costs of around €5,000.
A lot of time and effort from the patient, the Ombudsman and the HSE to resolve this case which can be avoided by using the services of Healthcare Abroad.
So with all the paperwork now in order, the matter was closed.
Healthcare Abroad makes sure all the proper paperwork is dealt with from the outset, so that your treatment proceeds smoothly and your care is reimbursed by the HSE.
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