The supervisory warning issued today by the ERS follows the regulator’s awareness of a “significant volume” of complaints from healthcare service users regarding the non-communication or incorrect and insufficient communication of the financial and administrative implications of the care provided.
In the alert issued today, ERS emphasizes that this situation has a “clear detriment to the freedom of choice for users.”
The information that providers should give the user — in advance, completely, adapted to each person’s capacity for understanding, and proactively — must include an accurate cost estimate for the entirety of care to be provided, namely exams, consumables, and drugs.
When it is not possible to make such a forecast, the regulator highlights that the user must be clearly informed of this impossibility and, whenever possible, warned about the relevance that missing elements might have on the total cost.
It also reminds that in the case of prolonged treatments, users should be informed of the total cost of the entire treatment and not just some of the included acts.
Users should also be informed about all essential aspects of healthcare provision, “including its administrative, logistical, and financial implications.”
In the context of providing healthcare under a convention or agreement with a third party entity (National Health Service, health subsystem, or insurance company), the regulator states that all information regarding the covered care and respective prices, the financial responsibilities of all parties, and necessary authorizations, such as in the case of insurance, should be provided to the user.
In the specific case of accessing healthcare under insurance and health plans, users should be informed about the costs to be borne by the provision of care, including the entire proposed intervention, “unless the respective provider, justifiably, does not have the necessary elements to provide this information,” it adds.
