Jul 26, 2025
3 min read
Ans Standard requires operators to respond in 10 business days.Kavarati, but regulate community plans.
Health plans should be made, inspection and procedures at the term established by National Nouncil for a healthy ads (adeb
Since this month, health insurance operators have a maximum number of time to respond to customer requests, but also the custom in the new standard.
Supplementary Health Expert Lawyer Ana Carolina Naverde analyzed the effects of the resolution in an interview with the podcast of well -being. Teerera kune:
Obligatory response and time specified
Normative resolution No. 623/2024 must ensure that all operators respond to medical treatment requests, the following dates:
- immediately, urgency or emergency;
- Within 10 working days, more complex roads and hospital options can be adopted;
- 5 business days in other cases.
According to the attorney, changes to users are important for users who fail to try to wait and gain power.
"Request" under the analysis as a way to perform the performance of the service ”
Negative must be formal and reasonable
The special request for a new decision is that if you deny a new decision, the operator must set the written sentence, even if the customer does not require this registration.
"If it is a refusal, it refuses in writing. It is possible for death, recently explained."
Before normal, many negative is made up of the negative format and appealed to the Ans, Procins or Judicial.From now on, the operator's contract cautious or how sources reject the rejection of laws.
The extension of extension and a $ 24h channel
Standard also determines improvements to consumer services.Operators must maintain service channels online, with 24 hours of operation, as well as Faceonce and telephone services required.
These dark dog dogs account account not with Saluto projects, but also to contractual issues as a network request.
"The user can also use these channels to complain or request information about personalization, cancellation, training, accredited network," Navarred said.
This request must also be answered on 7 business days.
At the norm
Anna Carolina warns that the solution is the only relationship between operators and users.Structural issues follow it.
Features in the middle and experts from the points from the new resolution:
- In the absence of clear backs to change to accredited Rede, especially in clinics and laboratories;
- Unlimited networks of interaction, but left millions of soft people;
- incentives for creating 'popular' plans, with limited scope, which eventually endanger the health of the consumer when they really need it.
"If you limit a product of limitations to 2 pages [...], it is a business model that family resources can catch, but it does not give services to the necessary integration."
The expert describes the problem of the settings as a fragile point: by 2024, the adjustment roof has set 6.06%for individual plans. However, these values are below the adjustments that are practiced in unlawful mass plans and often exceed two digits.
Nairdi argues that the control of the 80% market in the market.“The main standard and transparency is important for you to manage and common tasks.
The absence of private plans also adds conditions, especially among the elderly who lose business that lose their business planning program.
As a result, most clients are leading to rent joint settings with Fictj - an act known as "quivovity or FALSE".
"This time, when a family group is organized from CNPJ to hire an integrated system, we are next to the aircraft, depending on its situation."
Although this access form at first seems cheaper, later adjustments are higher.
Refund remains warranty for emergency
Lawyers, emergency emergencies, has the right to accidentally care even outside the network, including ADP costs.
For this reason, customer needs to indicate that you try to contact the operator and does not receive the correct service in the network.
"In this case, the Right to Review is incorporated," he said.
Complaints must be formal
Another point emphasized the rumors of Carolina's anomin, which on social networks are of no legitimate value.
"Uilt as you do in the network does not count. What is important."
An ANS evaluates the effectiveness of the operators based on the number of formal complaints.For example, the indicators can move the plan to suspend.
