Dear affiliate: In compliance with Resolution 4343 of December 19, 2012 of the Ministry of Health and Social Protection, it is important that you know the following information as a member of the Mandatory POS Health Plan.
The member will be able to access all the benefits plan health services from the date of enrollment or the filing date of the form or from the effective date of the transfer or mobility.
Recovery fees are the monies that a user must pay directly to the Health Service Provider Institutions (IPS), in the following cases:
- When a person is not affiliated with the subsidized regime and is identified at the level 2 of the Sisbén, will pay a 10% of the value of the services without exceeding the equivalent of 2 legal monthly minimum wages in force.
- When a person is identified in the Sisbén level 3, will pay up to a maximum of 30% of the value of the services without exceeding the equivalent of 3 legal monthly minimum wages in force for the attention of the same event.
- For people affiliated to the subsidized regime and who receive care for services not included in the Health Benefits Plan, they will pay 10 % of the value of the services.
- The population with the ability to pay will pay the full rate
Members of Comfenalco Valle EPS will have the right to transportation service in cases of emergency duly certified for transfers between IPS or in cases where patients are admitted to an institution providing health services and require complementary care. The IPS in which the health service is being provided may provide the transfer service if it has it, failing which it can contact the Telephone Exchange in the city of Cali, Yumbo and Jamundí at (57 + 2) 4853530 or from other cities 018000185462 to coordinate the authorization of the service.
- Virtual channel: comfenalcovalle.com.co (24 hours).
- Telephone channel: (57 + 2) 4853530 or from other cities 018000185462 (24 hours).
Likewise, EPS Comfenalco Valle has Comprehensive CIS Service Centers, in which information and guidance is provided to the user in a personalized way:
|Comprehensive Services Unit||ADDRESS||TELEPHONE||Customer Service Phone|
|CIS Life||Calle 5 No. 38 A - 35 Wing 2 Floor 4 Vida Building||4853530||4853530|
|CIS North||Avenida 3N No. 45 - 89||4853530||4853530|
|CIS South||Calle 13 # 64 - 30||4853530||4853530|
|INTEGRA HEALTH IPS SAS Cali - Rio Cauca|
Calle 75B No. 20-170 sector 7, floor 2
Rio Cauca Shopping Center, - L 220 al 226, B / Vallegrande
|Northeast CIS||Race 8 No. 52 - 164||4853530||4853530|
|INTEGRA HEALTH IPS SAS Yumbo||Carrera 6 No. 4 - 47, 2nd floor - Yumbo Business Center (Benalcázar Park)||4853530||4853530|
|CIS Jamundí||Race 10 No. 8 - 88||4853530||4853530|
|CIS Palmira||Carrera 30 N ° 27- 20||4853530||4853530|
|Spring of Life - Buenaventura||AVE. 41 No. 5 - 91 Outpatient Service||2417841 – 2418382||4853530|
|Santa Sofia Clinic - Buenaventura||Carrera 47 No 4 - 02 B / Bellavista||Emergencies and specialists 3 865 300|
|CIS Calle 5ta - EMCALI||Calle 5 6 - 63 Tower A floor 2||4853530||4853530|
The opinions and suggestions (complaints, claims, requests and / or acknowledgments) that you want to present related to: the service, affiliations, contributions, disabilities, free choice, among others, whether verbal, written, telephone or virtual, must be resolved by Comfenalco Valle EPS, in a timely and thorough manner, within the terms of the law.
As an affiliate, you can also make use of existing protection mechanisms, such as submitting a right to petition both the EPS and the IPS and other entities in the health sector. This right includes the right to request information, examine and require copies, make inquiries, complaints, reports and claims and must be resolved in a timely and substantive manner in the terms of Law 1437 of 2011 or the regulation that replaces it. Likewise, when trying to avoid irreparable damage, the member may request priority attention to requests.
These protection mechanisms can be filed either by telephone to the telephone line: 4853530 or from other cities 018000185462; virtually via the website www.comfenalcovalle.com.co section Contact Us; or in person at the CIS listed in the CONTACT US point of this letter.
In the same way, you can make use of the judicial recourse and if you consider it necessary, you can present your statement directly to the National Superintendency of Health and even request the "provisional cessation" referred to in article 125 of Law 1438 of 2011, when consider that by action or omission the life or physical integrity of the person is put at risk. The National Superintendency of Health, will advocate knowledge and will respond directly to the user of the SGSSS or through the corresponding EPS.
Users also have the possibility of going to the Ombudsman's Office, located at Calle 23 A No. 2N - 75 Cali, telephone: (57 + 2) 6615333 - (57 + 2) 6608856, email: firstname.lastname@example.org for Valle del Cauca, which is the body with a constitutional mandate that ensures the promotion, exercise and dissemination of human rights; or to the Departmental Health Supervision Office of Valle del Cauca.
Members of the EPS Comfenalco Valle can go to the association of users, public hearings and citizen consultations, know the data of contact here