Tuesday, June 18, 2013

Hospitals and Health Insurance

While my surgery might be painful, the overture is it already: Negotiating with health insurance and hospital. The latter isn't able to explain the costs properly, and the insurance goes strict with the rules. I learned, that doctors don't really like to talk to insurance companies (or even patients). So, it is quite hard for the Health Insurance to get proper information.

My doctor yesterday at Samitivej wasn't even able to open my file on his computer. He said, it is not his job, so his assistant had to do it. The problem now is that (so the doctor explained to me) they may need to fix my supraspinatus and infraspinatus tendon with something like small screws or anchors and will charge 70.000 Baht for this. They called it an implant what is not covered by insurance, and the insurance company asked - for a reason - why some screws are quoted with 2000 USD.

My job is now to be the middle man between the two companies (yes, hospitals are mainly a business here). It seems that Samitivej, although selling quite aggressive, would risk the deal instead of just talking with my health insurance. They didn't even offer me to call the insurance, so I had to do this.

It turned out the screws are actually more anchors and will remain in the body - and that's the difference. This is called an implant, and has to be paid by me :-(

Since my should really hurts, I have to bite the dust and undergo surgery - and it will be at Samitivej, since they did all  the preliminary examinations already.

I had two surgeries at Bumrungrad before, and while the nurses and administration staff is great there, the doctors also try to not spend too much time with you. I learned that most doctors in private hospitals are basically freelancers. That explains why it is so difficult to get an appointment - they are in in the hospital of your choice only on certain days.