Filenews 11 September 2024
Entries that do not correspond to reality are detected by the Health Insurance Organisation in the GHS software. Doctors are found to record visits of their patients on days and times different from those on which they took place, patients receive e-mail messages that they have been served by a doctor other than the one they had visited, with the result that, when a dispute or complaint arises, there is a risk of serious legal problems.
Incorrect registrations, which may seem "innocent" but do not cease to be an offence, certainly cause problems in the smooth operation of the General Health System, the director of the Organization Konstantinos Panayides told "F" and explained: "Reports have reached us concerning doctors who, due to the restriction that exists in the units they are entitled to use each month (after completing a certain number), have reached us units, per specialty, per month doctors stop being compensated) and because the services they offer on weekends do not count towards the monthly total of credits, they serve their patients, for example on Wednesday but enter in the software that the visit took place on Saturday." This practice, Mr. Panayides said, "causes problems because, on the one hand, reality is distorted and, on the other, it is an offense that cannot go unnoticed."
In other cases, he added, "we have realized that while the patient is served by a doctor, the visit to the software is registered by another doctor of the same specialty. This is usually done in the case of hospitals or multi-clinics."
In these cases, "other issues and questions arise. For example, if something goes wrong and the patient wants to file a complaint against the doctor who served him, then there is a problem. In the GHS software, the patient appears to have been served by a doctor, who may not know the beneficiary, but in fact the doctor the patient visited and advised him about it or prescribed medication, etc. is another. So what do we do here? When the patient files a complaint, which doctor should be investigated to be correct and with the law?"
In addition, "we find that in the case of hospitals and multi-clinics, prescriptions for medicines or referrals for laboratory or other tests are issued by a doctor other than the one who served the patient. That is, the doctor who served a patient can inform his patient that he will issue a referral for laboratory tests, but the patient in the email he receives then sees that the referral was issued by another doctor, whom he often does not know. Again, it is an offence on the other hand, and there is also the possibility that legal or other problems may arise in cases where there is subsequently a dispute."
Therefore, "we as the HIO, when we noticed these phenomena had to react in some way and we chose, in the first phase, to call on our providers through the Directive issued to be particularly careful, to comply with the legislation and to record the real data in the IT system. The data must be recorded correctly, relating to the actual data and the actual services offered by each provider to the beneficiaries"
In cases where, "such incidents are investigated and it is proven that incorrect entries were indeed made, the HIO certainly proceeds with all legal procedures, imposes fines, etc. and certainly there are cases that, due to their seriousness, lead to termination or suspensions of contracts".
The circular sent by the HIO specifically states: "The Organization recalls the great importance it attaches to the correct, accurate and complete registration of data in the GHS IT system by all providers" and adds: "Any kind of false representations is a serious offense for which strict penalties are provided by law, which include, among others, a possible contract termination."
Therefore, "please pay particular attention to the correct, accurate and complete registration of data in the GHS Information System in accordance with the announcements issued by the Organization from time to time".
