May 25, 2022

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Can APS serve customers well?

Can APS serve customers well?

Since January 1 of this year, Amil’s Individual and Family Health Plans are managed by APS (Personal Healthcare). Before that, it was a small company, with only 11,000 clients. Suddenly, the health care provider became responsible for the lives of 337,000 people, with the transfer of working clients.

Focusing its performance on the countryside, it has now changed hands to manage clients in São Paulo, Rio de Janeiro and Parana. consumers Report loss of previously contracted hospitals and laboratories and difficulties in scheduling routine exams.

Experts question the company’s ability to serve newcomers with high quality. APS claims to have the tools to provide assistance to users.

The company declares that its goal is to “deliver high-quality medical care that respects ethics, and promotes health in an integrated, humane manner.”

The lawyer says the transition is difficult

For Frederico Glitz, a lawyer who specializes in contract law, APS’s entry into this department causes a “distrust” of its capacity. It is reported that the operator must strengthen the professional team to meet Worker clients migrated.

“Managing over 330,000 contracts is not easy. Even large companies have time to adapt to the new reality. It is not something that needs to be done overnight.”

The fact that the company is headquartered in Jundiaí, within the city of São Paulo, also raises questions about management. That doesn’t get in the way, says Glitz, as long as the company supports the consumer.

“I think that APS has to create a local structure to implement this detailed management. It has to assess the consumer profile, that is, the age group, the rate of disease. And the consumer in São Paulo has a different need than that in Curitiba,” he says.

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Can a withdrawal of accreditation occur?

Consumer law attorney Patricia Santos believes that customers leaving Amil should be aware of changes to the approved network.

It recommends that users keep documentation, such as hospitalization records and exam reports, to substantiate any changes in this regard. He declares that “the fear that began is the cancellation of the network that will be provided by the APS. There were already complaints about the loss of hospitals and laboratories before this transfer.”

Analysis proves ability, according to APS

interrogated by UOLAPS says economic and financial analyzes conducted by the National Complementary Health Agency (ANS) prove its efficiency in serving the new beneficiaries.

“APS provided an exclusive call center to guide people during the relocation process, assuring them about continuity of coverage stipulated in their contracts, maintenance of the approved network, continuity of ongoing treatments and full compliance with health plans regulations,” the company note says.

More than 20 years in the market

APS is a subsidiary of UHG (United Health Group), owner of Amil. Its current partners are Amil itself and Santa Helena Saúde, which is part of the conglomerate. But APS is sold by the group.

On February 8, however, ANS Stop selling the company’s operations For a group made up of three controllers: Fiord Capital, investment manager, Seferin & Coelho of hospital management, and CEO Henning von Koss, who has experience managing other health plans. The value of the negotiations is estimated at 2.34 billion Brazilian riyals.

“Nothing changes for the beneficiaries, who are still receiving the service from the same authorized network, with the support of the same terms of contracted services and under the same regulatory agency rules,” APS said in a note at the time.

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A site with little information

a APS . site It collects a little content about the history of the company. It only says that it was founded in 1999. There is even a file The second title hosted on Wix, which contains outdated information about the company, with inaccessible links. The company has no profiles on social networks.

APS has been a member of Abramge (the Brazilian Association of Health Plans) since 2014. Approval of a newcomer depends on the fit of contract forms and business products to ANS rules, as well as registration of the social contract with the regulatory agency, says the class entity.

Profits above 6 million Brazilian riyals

In September 2018, APS was acquired by the group that controls Amel. Jundiaí’s operator was part of the Sobam Group, which was also sold with the Sobam Health Plan, Pitangueiras Hospital, and eight medical centers. The purchase price was not disclosed.

In 2020, the last available balance sheet, APS reported a profit of R$6.466 million, according to the company’s financial report. The document shows that there were cost cuts in the first year of the pandemic, highlighting only the renegotiation of property rents.

In terms of investments, the telemedicine app mentions to the beneficiaries of its own network. It also reports that it has made available a nursing specialist in the call center service to answer users’ questions about COVID-19.

In the first half of 2020, there was a “sudden and relevant decline” in Medicare in the approved network, prompted by social isolation and restrictions on activities. This, according to the worker, brought “positive results”.

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With consultations, exams, and surgeries resuming from July 2020, the company increased its expenditures and achieved a “reduction in results,” the financial report summarizes.

An extract from the document reads: “Despite the challenges in the face of the pandemic and its consequences, the operator ended fiscal year 2020 with a satisfactory net result, with sufficient collateralized assets and a good solvency margin.”

Balance APS It was followed by an independent report by audit firm Grand Thornton. The 2021 financial report is not yet available.