Hospital insurance write-offs: tackling administrative challenges requires proper resourcing

Sir, – I refer to a recent article in which John McManus claimed that senior medical consultants are the “number one reason” why €125 million in private health insurance claims was written off by public hospitals between 2022 and 2025 (“Consultants are to blame for the €125m in insurance written off by hospitals,” October 28th).

This assertion contradicts the evidence provided by the Health Service Executive and the Comptroller and Auditor General to the Parliamentary Committee of Public Accounts.

In fact, of the €125 million that was written off between 2022 and 2025, €71 million was deemed by the HSE to have been “correctly” written off. Another €37.6 million of the €125 million was written off because claims across all national acute hospitals were not submitted within insurer timeframes.

Internal administrative errors, lack of capacity to follow up complex claims, incorrectly registered patients, arbitrary insurance deadlines and lack of required patient signatures on relevant forms are among the numerous reasons why claims would not have been submitted on time by hospitals.

Timely consultant sign-off is just one part of the process and it is hindered in circumstances where Ireland has the lowest number of medical specialists per 1,000 population in the EU at 1.77 – 34 per cent below the EU average. Expecting overstretched consultants to prioritise paperwork over patient care is unethical, not to mention inefficient and inappropriate.

However, in cases where hospitals have dedicated teams within their finance department who review private patient claims, significant increases are seen in their private health insurance claims income.

Hospital consultants remain fully committed to upholding the highest standards of governance and ensuring that the public receives the best possible value for money from their healthcare system.

The consultant body, the Irish Hospital Consultants Association, remains fully committed to supporting efficient hospital billing; however, meaningful progress requires systemic IT improvements, dedicated administrative support, and fairer claim submission timeframes from private insurers.

Our members see firsthand the pressures facing patients and their families every single day, and we care deeply about ensuring public money is spent effectively. Addressing these administrative challenges requires proper resourcing and constructive investment.

Wrongly apportioning blame is the easy bit; understanding the reasons and addressing the issues is a much more effective place to start. – Yours, etc,

PROF GABRIELLE COLLERAN,

President,

Irish Hospital Consultants Association,

Dublin.