Dental Health Care: Dentists Bill for Services They Never Provided
The AGN said that professionals also charged more than their share. In addition, there are no documents that specify the process of selecting a provider and issuing payment orders without the signature of the area responsible, nor the justification of the amounts. In the entity’s filing cabinets they have boxes "wet and eaten by rodents"
Several dentists from the Health Care of the Judicial Branch of the Nation (OSPJN, for its acronym in Spanish) presented bills for services they never provided and for amounts greater than their due.
The information is contained in a file instructed from the OSPJN itself, which was analyzed by the General Audit of the Nation (AGN, for its acronym in Spanish) in a work approved in May of this year on data of the period 2005-2007.
It is that on April 3rd 2007, the Legal Counsel of the Health Care provider asked its accounting area for the detail of the billing of professionals, especially dentists, because it had "lost" documentation on providers. It was in that file that dentists "have recognized" irregularities in their bills. In fact, and from the revelation, AGÑ adds that there were "refunds in favor of OSPJN for $ 25,418 for quarterly billing and an equivalent deposit was made for any errors in other settlements."
In the same file of the Legal Department, entitled "Investigation without invoicing without Section Dentistry,” other observations appear, such as payment orders with dates of issue prior to the invoices that are settled, or 97 cases of budgets Duplicates that appear in at least two payment orders for a cumulative value of $ 206,422.
In addition, in a payment order, there is a backup rendering form where "a code that adds to the total is added by $ 7,280 without any basis." And, in several monthly surrenders, budget transcripts were attached with values greater than those in the original papers "with the initial addition of one or two digits."
On the other hand, the AGN report analyzed a sample of 173 payment orders and detected that, in the selection of the providers, in 33 cases "there is no precedent of the selection process" of the professionals, this implies that the agency - the OSPJN - lacks the documentation that provided for the incorporation of the provider as such."
Likewise, the Watchdog observed that "most of the files do not include the provider's curriculum", and there is no history of the analysis and the general evaluation that must be done by the Medical Audit of the Health Care.
The AGN verified that there are payment orders that do not have the signature of the area that issues them and that, "in general", do not include documentary evidence that supports and supports the settled amount to be paid. There were also two forms with global amounts without details, one signed by the General Directorate for $ 68,941.27, and another with the signature of the Administrative sub directorate for $ 59,455.30.
In response to a request for documentation by the Audit, regarding the "conformity of the service", OSPJN had responded that it was impossible to satisfy that request.
The Health Care Company accumulates documentation that, due to its quantity and volume, occupy a considerable physical space that exceeds the capacity of its administrative headquarters, in Lavalle 1653. To free space, boxes are periodically moved to the file that is in Villarino 2010, in the neighborhood of Barracas.
The Audit inspected these facilities and discovered a number of boxes "in poor condition, wet, eaten by rodents, crushed, open and with their contents scattered on the floor." At the same time, according to the technicians of the AGN, it was evident the "absence of criteria of organization, registration and classification". In fact, three random boxes with papers corresponding to the dental benefits were selected, and it was concluded that "there is no methodology by which the archived documentation can be correlated with the payment order that was generated."
However, the auditors also stressed the "poor quality of the building facilities, with waterlogged sectors and without adequate space for permanent staff". With these findings, the Watchdog completed its report ratifying the arguments of the Social Welfare of the judiciary regarding the impossibility of delivering the documentation that had been requested.