- All health service providers are exposed to receiving a medical complaint against them.
- This process is managed by Conamed and its job is to help achieve a peaceful resolution of any conflict.
- Knowing everything related to the procedure is quite useful to be able to be protected in case of facing a case of this type.
The legal part is one of the most important in the field of health and also one of the most unknown. The reason is because students are not told enough about this topic while they are in college. Therefore, when they start their professional life they are helpless and are unaware of most of basic concepts such as medical complaints.
In this case it is a Petition through which a natural person, for their own interest or in defense of the rights of a third party, requests the intervention of the National Medical Arbitration Commission (Conamed) to reach a solution. It is generated when there is a refusal of mandatory medical services or irregularity in their provision, as long as they are of a civil or medical care nature.
In this case, the job of the authority is to achieve a peaceful solution and where users (patients) and medical service providers can reach an agreement. From the beginning you must adopt a neutral position to never show favoritism towards a party.
Something important is that the medical complaint It can be filed against any health service provider. It does not matter if it is from a public, social or private institution.
What does the arbitration process consist of?
The medical arbitration process begins with the admission of the complaint and is integrated into two stages:
In the conciliatory stage the conamed It does not rule on the merits of the matter because at all times the will of the parties is taken into account so that they decide the way to solve the controversy and the agreements to which they commit. The conciliators will be able to make the settlement proposals and create the appropriate conditions seeking the solution of the conflict.
The decision-making stage or arbitration represents another alternative of first intention or when a solution was not reached in the conciliation stage. In this part, Conamed does rule on the merits of the matter because it is appointed by the will of the parties as Arbitrator to definitively resolve the controversy, by issuing an award that is legally effective because it contains the normative assumptions that allow them to be given legal certainty. .
What are the requirements for the admission of a medical complaint?
They are those established in article 49 of the Regulation of Procedures for the Attention of Medical Complaints and Expert Management of the National Commission of Medical Arbitration. Where it is established that complaints must be presented to Conamed personally by the patient or through a person authorized to do so, either verbally or in writing and must contain the following:
- Names, telephone numbers and full addresses of the patient, of the person submitting the complaint and of the medical unit or service provider to whom you are complaining.
- A brief description of the facts that are the reason for the complaint indicating: what happened, where it happened, how it happened, when it happened, who is the provider of the service or medical unit, what is the reason for the complaint, what is your request to the provider of the service you are complaining about and if you present it in writing, your original signature and, if this is impossible, your fingerprint. For quick reference, you can consult the Guide to filing a complaint.
- A copy of the appointment card where the patient’s affiliation or registration number appears, when the complaint is against public institutions that assign a social security or registration number to patients.
- What is your conciliatory request towards the service provider of whom you complain.
- In the event that the patient is not the one filing the complaint and someone else does, request guidance on how to prove representation. With what document can they represent the patient, since, depending on the case, it can be: simple power of attorney with a copy of the identifications of all the signatories, copy of the birth certificate, marriage certificate, power of attorney, guardianship testimony, executor or will.
- For an adequate and personalized analysis of your case, a simple, legible copy of identification with photograph and signature will be added to the complaint, a simple copy of the documents that prove the doctor-patient relationship, which are related to medical care and that support the facts stated, for example: notes, medical prescriptions, appointment cards, hospital discharge sheets, clinical summary, laboratory test results, invoices, receipts, payment vouchers and any document that can help in the analysis of the case.
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