Huge Hike In Hospital Bill If Patient Choose To Pay Directly: Report (image: Pixabay)
Hospital bills are not going to easy, if the patients chose to pay directly without resorting to insurance, a recent Times of India report reveals. Rema Nagarajan”s investigative piece titled “No Insurance? Be Ready To Cough Up More At Hospitals” delves into the horrific details of “standard practice” at some hospitals if the the patients decided to pay up the hospital bill themselves than through insurance company.
The TOI“s report traces an incident occurred to a patient who was admitted to the Fortis Hospital in Gurgaon. A 53-year-old patient attended the hospital doubting food poisoning with fever, diarrhoea and dehydration on April 14. After three days, he got discharged and as he decided to pay the amount from pocket, but the bill surged nearly 27%. When enquired, the hospital informed the patient that it was a “standard practice” for the amount to be spiked if patient opt to pay directly.
The patient recounts about the hospital facilities which was charged to cost the higher amount. When he got admitted, he was provided with a twin sharing room which was charged Rs. 8,400 per night, similar to a luxurious hotel tariff rate in Gurgaon for a single room. Aside from the room rent, several facilities including nursing services, linen and laundry, admission charges, bio-medical waste disposal all need to be paid separately.
The patient told TOI that the hospital delayed informing the insurance firm and failing to receive the insurance approval at the time discharge, he offered to pay the bill which then surged. Until April 27, the insurance firm had not proceeded with said patient”s insurance claim, the TOI reports.
When the newspaper outlet enquired about such practice, it come to their notice that it was followed as a “standard practice” for hospitals to hike the bill amount of patients if they chose to pay directly, than the discounted rates given to insurance companies. However, this practice has not conveyed to the patients prior and no notice or board has been placed outside hospitals informing the same. In many hospitals the difference is close to 10%, the report adds.
“To charge a patient 27% more is plain loot. If anything, the patient paying directly ought to be charged less as the hospital is getting the money right away instead of having to wait for the approval process and so much back and forth with the insurance company asking for several clarifications on the bill. In fact, in many smaller hospitals if they charge the patient less if they pay directly,” TOI reports, as a Doctor is saying.
Anurag Goswami, a TPA representative tells the news outlet that insurance companies get “negotiated rates” as they bring them business or customers. Patients are referred as customers. And these negotiated rates vary for different insurance companies. The representative adds that if there is fraudulence in the insurance through bank or through company, one can approach RBI or IRDAI. But in the case of private hospital, aggrieved party cannot go anywhere since they have no governing authority and hospital is well aware about that.
Meanwhile, the Fortis Hospital responded that they have initially given the tariff rate to patient in accordance with their contractual responsibility with Manipal Cigna insurance (Mediassist-TPA) for his hospital stay. When the patient opt to pay directly, “as a normal industry-wide practice, standard hospital tariffs were applied and contractual discounts with Manipal Cigna were removed, resulting in an increase in the bill amount.”
