Exclusive: Hospitals are concerned about EPS 'obstacles' in electronic billing

The document, which EL TIEMPO learned exclusively from an IPS who reported the incident but preferred not to reveal his name, warns of the problems that health service providers have encountered when submitting their invoices, which in many cases leaves these entities unable to collect payment for the services they provide and worsens the financial situation they face.

The problem has arisen, according to the ACHC letter, since February 1, 2025, when the Ministry of Health and Social Protection began the process of collecting information on health care and resources invested in the system, through the implementation of the Electronic Sales Invoice (FEV) that aims to guarantee transparency and regulatory compliance and the Individual Registry of Provision of Health Services (RIPS) and optimize the quality of services.

However, the IPS, that is, hospitals and clinics, have been reporting great difficulties due to the demand for additional requirements to the norm and the imposition of barriers that prevent them from filing accounts by the EPS.

“As you will understand, Mr. Vice Minister, at a time when there are constant difficulties with the flow of resources, not being able to file the bills for the services provided by the IPS will increase the liquidity problems. In fact, according to what our affiliated IPS have reported to us, the percentages of billing filing are one third and some barely reach 10% and being halfway through the month, a very complex situation is looming,” states the letter sent by the ACHC.

According to the providers, the EPSs are requiring documents that make it difficult to file these invoices through the billing structure, which is JSON, or by presenting requirements that are not in Resolution 2275 and the technical document issued by that Ministry, which are those that regulate this new model for submitting invoices.

For example, some EPSs ask the IPSs to include the Unique Verification Code, unaware that it is the EPS itself that must extract it and make the corresponding cross-checks, adding more processes that do not correspond to the provider.

“A prohibited practice that became popular a few years ago is related to the issuance of authorizations in the due time. In this interoperability process, this practice has not been overcome and some Paying Entities, despite dealing with services already authorized and provided by the IPS, have established the requirement of issuing authorizations after the discharge of patients; this situation delays the process of generating the Electronic Sales Invoice because it is a JSON requirement that if it is not present, the process cannot advance; that is, the IPS is subject to the times and will of the EPS,” the letter emphasizes.

The hospital and clinic association also reports that some EPS have made configurations in their platforms, arbitrarily defining different JSON fields, causing the system to report an error when the IPS uploads the data and prevent the filing. For example, some have defined a diagnostic code that, if not entered, does not allow filing. The EPS are also said to be closing the platforms at times and dates not defined in the standard, which prevents and interrupts the filing process.

The letter points out two specific cases of EPS that are currently under intervention: Nueva EPS and Savia Salud. In the case of Nueva EPS, some report that despite uploading the JSON and XML in accordance with the instructions and the training received from them, the invoices are rejected indicating “RIPS does not have CUV”.

Savia Salud, for its part, despite the fact that the mechanism has been in effect since February 1, did not make the corresponding adaptations for the reception of JSON and only announced training for the service provider network on Thursday, February 13 to begin filing with the new methodology.

“As you can see, Mr. Vice Minister, the regulations are not being complied with and therefore they are moving away from the established spirit and purpose. The IPS, in the natural anguish that arises from not being able to file the accounts, even if they wanted to access the arbitrary decisions of the ERP, would have to carry out a specific development for each insurer, which generates higher costs and delays, and goes against the spirit of this mechanism to standardize the filing processes. We hope that with the previous descriptions and examples of the situation, the appropriate corrective measures will be adopted, the compliance with the resolutions and the instructions will be reiterated through an administrative act – if necessary – and alternative mechanisms will be structured to correct the filing of accounts and the transfers, in case the situations described cannot be overcome in the immediate term,” the letter concludes.

In addition to the obstacles received by the EPS for the filing of invoices, another letter also known exclusively by this newspaper and sent directly to the Minister of Health, Guillermo Alfonso Jaramillo, by the general director of the ACHC, Juan Carlos Giraldo, also insists that the current financial moment that hospitals and clinics are going through is critical and that is why they are asking for "help."

In the document, the union makes a series of requests, such as ending the ceiling on paying providers 80% of what they bill, since the remaining 20% ​​is a portfolio that has been accumulating and widening the gap in the institutions' finances, since many times the EPS does not even reach 50% in the payments and they are asking the Government to pay them 100% of what is billed for a service already provided.

The union also calls for moving forward with a new phase of releasing technical reserves for payment of old debts; expanding Findeter's credit line; using mechanisms such as portfolio purchases; making the use of the half-point of social VAT even more specific to resolve outstanding debts; among other points.

“Mr. Minister, the service sector is not stopping, it continues to function, it maintains operations and assistance to the entire population, but it requires help and protection to continue acting as it has done until now and in the most difficult moments. Please attend to our repeated request for help,” the letter highlights.

Environment and Health Journalist