Singapore Expats

sorry if there's already a post on this--too mad to look right now!

My husb just got back from the hospital for kidney stone treatment, no overnight stay but urology consults, x-ray, and ct scans were involved.

When he was ready to come home he called me as they were expecting him to pay...he was doped up and still hurting (in wheelchair) and didn't even have his wallet really--as we went in together and I left him to come home and attend to our child.

I was furious that they were trying to coerce him into producing a credit card and would not just send us a bill or let me come in and pay tomorrow. I never pay a medical bill without scrutinizing the itemization, since I was once double-billed (and paid twice as much...it took months to recover it) on every service and med.

I gave the receptionist a bit of a tirade and she compromised that I could come in and pay it and she took my hp #...but still...

do they not send bills here?

the bill wasn't even that high, just a bit over a thousand, but the principle of it really ired me.

(and yes, I was going to go collect him but he said he just wanted to get home ASAP, so they wheeled him to a taxi...)

No as a rule they don't issue bills...

If your insurance company is going to cover AND has an agreement with the hospital...

Then you can get them to issue a guaranty of payment and arrange direct billing to them.

However the rest of the time you pay before leaving... that's the way it is...

And usually even where there is a guaranty of payement... you are not discharged before you leave them a credit card imprint and a disclamer that you will still be billed for any amount your insurance company refuses to pay.

They didn't even show him the breakdown, just a number.

Really?

Nope. That's the way it is here. Unless you are a citizen covered by Medisave/Medishield, but even then they try to get you to pay before you leave. I've done the kidney stone thing w/ultrasound destruction myself! But most recently, it was a medicated Stent for my wife which had us looking at a 13K bill. But after Medisave/Medishield and some interesting maneuvering by her Cardiologist, we were left with a smidgeon over 2K to pay out of pocket. Which they send me a bill for. I think the difference here may well be that my wife is a Singaporean and I'm a PR and we own property here.

Of course a lot of it has to do with people like this thread:

http://forum.singaporeexpats.com/ftopic ... highlight=

There are some privacy issues that are horrifying to me, as well.

A friend of mine was ill and sent his wife to the doctor to pick up a prescription for him. Just to pick up the prescription, mind you.

While the wife was face to face with the doctor, he discussed the results of the patient's (my friend's) bloodwork *before* calling my friend. He named specific details, concerns, etc. never considering that the patient may not have wanted to share EVERY DETAIL with the wife.

And here's the best (worst) part: he did it in the waiting area, in earshot of several strangers!

Where I'm from, a doctor could lose his license for this.

Yeah, but you're not home.

Welcome to Asia.

sundaymorningstaple wrote:Welcome to Asia.

I'm from a fellow SEA nation and I'm apalled by the empathy (or lack thereof) and handling of privacy of 'professionals' here.

I'm glad you ' ' professionals, because here they ain't! Maybe I should have just said 'Singapore' like I originally wrote. I changed it as I though I'd be castigated for singling out Singapore - got whacked anyway!

I think it's sort of similar in most Asian countries. We dont have Doctor-Patient privacy or confidentiality unless we requested. Mostly doctor speak first to whoever responsible for patient (wife, husband, relatives and sometimes even friends) any good or bad news regarding the patient. Then the patient family will discuss how and when to let the patient know.

In terms of Singapore doctors, my family have a long history with doctors from SGH. To make story short, my mother who had acute anemia came to Singapore to attend my brother graduation a few years back. During her stay in Singapore, she discussed with hematologist at SGH as she wanted to inject preneumonia vaccine. Her doctor gave her green light. Within 24 hours, she became terminally ill with high fever. For the next one and a half years, she had spent in and out of hospital in my country and also at SGH. No doctors could identify what is wrong with her. Only on her last trip at SGH and later at Mount E, they diagnosed her with MDS (which is also known as preleukemia). The vaccine had flared up her anemia and later changed to leukemia. As my father being diplomatic official, the hospital was given what they called VIP service but took them a long time to diagnose. Different doctors everyday to rule out the possibility of every major illness that they can find. Test after test, x-rays, scans, anything to find out what's wrong with her. Took them six trips to SGH (at least one month per trip) to find the illness. At the end, she had to go through blood transfusion and injection every four days which cost 1k per injection. She survivied only two months after her diagnosis. Throughout the time, the hospital assigned another hematologist to my mother case but never once admitted that it was due to their doctor suggestion on vaccine that started the whole thing.

(insert House reference here).

Gee, I'm no doctor but the first I would do is look/ask for history and surely the pre-pneumonia vaccine would have come up (or it did but they were in denial?).

Actually installment is possible, when the amount is considerable, you just tell them that 2 or 3k is too much to pay out if you are on low income, my bill and i say bill because it was sent to me, was paid over a year! Though if they can extract your teeth, they will, (pay cash) who wouldn't! Most business would prefer cash.

They are actually not that bad, to discuss with, so just tell the cashier you would like to arrange a payment, if you are tight for cash. They are not unreasonable at all, and lets face it, if you are broke and the work is done, what option do they have!

Though billing is not a normality and not to be encouraged! Many lives may depend on the system of billing, so like most things here its case by case.