Only Ops done in Operating Theatre Can Claim??

[Mustank]

http://www.asiaone.com/News/Latest%2BNews/...802-362831.html

 

Retired businessman Steven Choo, 60, underwent angioplasty at the Singapore General Hospital (SGH) to unclog blood vessels in his legs last November.

 

Mr Choo, who is diabetic, underwent the procedure - with "balloons" and stents used to unblock the arteries - which prevented gangrene from spreading from his toes.

 

But the successful operation marked the start of another round of problems for him. On the day he was discharged from hospital, he received a shock: His medical bill came up to $14,501, but Medisave and MediShield would cover only $900 and $810, respectively, or $1,710 combined.

 

SGH also told him he would not get his $6,620 deposit back, and that he still owed it $5,381, Mr Choo told my paper in an interview. The remaining $790 was covered by a government grant.

 

The Central Provident Fund (CPF) Board told him that the Medisave claim submitted by the hospital did not indicate a surgical procedure. This meant he could not claim the full amount he should have been entitled to: $3,050.

 

Insurance company AIA, which handles his MediShield account, told him likewise.

 

Mr Choo then hand-delivered a four-page report from his doctor to the CPF Board, explaining that angioplasty is a surgical procedure. But then he got another shock.

 

He said: "CPF Board wrote to tell me that they're not paying because (the angioplasty) was not done in a 'proper' place."

 

The CPF Board's letter, dated Feb 8, read: "Only surgical procedures performed in a properly equipped operating theatre... are Medisave claimable."

 

The head of SGH's diagnostic radiology department, Associate Professor Tay Kiang Hiong, told my paper that Mr Choo's angioplasty had been planned to take place in an operating theatre. But his operation was moved to an angiography suite - where angioplasty is also typically conducted.

 

This was because "there were urgent and complicated cases that needed to be performed in the operating theatre", said Prof Tay.

 

Mr Choo then sent an e-mail message to the CPF Board arguing that he had been penalised because of where his operation was conducted.

 

The case remained in limbo for three months, said Mr Choo, who wrote to the CPF Board repeatedly, only to receive the same reply each time that his appeal was under review.

 

In May, the Ministry of Health (MOH) sent him an e-mail message informing him that his appeal had been successful.

 

Not long after, Mr Choo's MediShield claim was also approved.

 

AIA told my paper that the claim was reviewed twice because there were inaccuracies in the initial claim.

 

Late last month, SGH called Mr Choo to tell him that both Medisave and MediShield amounts due to him had been paid out fully.

 

He was also entitled to a $638 refund from his deposit.

 

Six months later, the problem has been resolved but it has left Mr Choo irate. He said: "If I did not fight for it, where would I get the money from?"

 

Mr Choo added that he hopes that others would not have to be put through the same ordeal.

 

An MOH spokesman told my paper that angioplasty typically takes place in operating theatres.

 

As Mr Choo's angioplasty took place in an angiography suite, it "was not deemed a surgical procedure".

 

This is why SGH did not submit a Medisave claim for the procedure, said the spokesman.

 

The spokesman added: "We have since clarified with SGH that an angioplasty procedure... can be submitted for Medisave claims, even if it took place in the angiography suite."

 

i doono what the fark is going on in these mofo's minds it is not like the ops was done in some backyard clinic or some joker's home shouldnt SGH champion Ah Lau's cause since they are the ones who don have enough ops theatre KNN!!! Poor Ah Lau got to champion his own cause!!!! Hai Ah Lau boh form for 6 months!!! only one thing to say:

 

Kan Boh Standard

[Gee]

another bureaucratic flop?

[Rustyz]

Not $8 meh? Bloody joke

[Watwheels]

These 2 organistations should be well linked & working hand in hand but no, they prefer to email lai email qu, wasting patient's time appealing back & forth. I believe the Mr Choo is not the only one. Other patients who face the same problem most likely LLST paid up the bill out of pocket.

Edited August 2, 2012 by Watwheels

[Jman888]

These 2 organistations should be well linked & working hand in hand but no, they prefer to email lai email qu, wasting patient's time appealing back & forth. I believe the Mr Choo is not the only one. Other patient's most likely LLST paid up the bill out of pocket.

 

 

ISO procedures?

[Mustank]

Not $8 meh? Bloody joke

 

yah ah, why no $8?

[Watwheels]

ISO procedures?

Seriously, it's a sign of of over capacity in the hospitals. Operating theatre also not enough. I can also imagine the doctors & nurses working round the clock with little or no rest dealing with this kind of admin issues.

Edited August 2, 2012 by Watwheels

[Liping24cn]

The key word here is Authorised Workshop analogy.

 

[Galantspeedz]

i am sorry to say but education plays a part... and most that handle these claims aren't really very educated thus they go solely by the book unless told otherwise....

[Mockngbrd]

Gahmen dun let u use your marney

[Jamie1982]

strange that insurance company when at that point in time

the insurance company never verify or even check if what you write in the application form is right or wrong

but after signing on the dotted line

and after you need to claim

they will comb it with a very fine comb

 

 

 

 

[Jim]

I told you so. Those who laugh at Europe for their high taxes due to their "socialised medicine" simply has not encountered Singapore's very "capitalist" sea of red tape that protects your Medisave and Medishield from you.

[Lattesurf]

Is a dentist room at a polyclinic considered a surgical room?

It's not a clean room or whatnots u have like a typical hospital surgery room. Just that chair with the water dispenser and stuff.

 

I had my upper wisdom tooth extracted as a surgical procedure there, and claim everything from medisave.

[Qpik]

Mr Choo should seek Mr Khaw Boon Wan out at Meet-the-MP at Sembawang

[Qpik]

i am sorry to say but education plays a part... and most that handle these claims aren't really very educated thus they go solely by the book unless told otherwise....

 

i concur with your statement, most of the staff now from overseas. n not educated abt the health system like medisave.

[Ender]

i doono what the fark is going on in these mofo's minds it is not like the ops was done in some backyard clinic or some joker's home shouldnt SGH champion Ah Lau's cause since they are the ones who don have enough ops theatre KNN!!! Poor Ah Lau got to champion his own cause!!!! Hai Ah Lau boh form for 6 months!!! only one thing to say:

 

 

It was SGH who initially deemed Ah Lau is not eligible, as they did not submit the surgical claim for him.

 

As Mr Choo's angioplasty took place in an angiography suite, it "was not deemed a surgical procedure".

 

This is why SGH did not submit a Medisave claim for the procedure, said the spokesman.

[Hotshot85]

Frankly, as a staff in SGH, alot of protocols are pretty much damn f***ed up.

[Vid]

You had an accident. Your insurer told you to go to their authorized workshop. You went there but workshop is full of cars with no space for you to enter. The mechanics there told you no worries as they can just do it just outside the workshop since your problem is not a major one and they only have to bring their toolbox to your car. Once done, your insurer told you that your claims for repairs done is not approved because the job was not done INSIDE the workshop... :wacko: