Itemised bills can reduce ballooning of claims

I would like to offer my experience using my company's zero-payment health insurance policy to show why greater transparency in medical billing from private clinics is necessary to prevent the ballooning of claims and overcharging.

My company's employee health insurance policy does not require me to co-pay, and provides full coverage for medical treatment.

I found that clinics did not give me any itemised billing as they said the practice was to send the bill directly to the insurance provider.

When I asked for a copy of the bill to make sure it was accurate, I was told I would have to request it from the insurance provider or my company.

My company said it receives only the total sum accrued by all employees who have sought medical treatment, and not itemised bills.

Eventually, I found the procedure to get my own medical bill so tedious that I did not end up checking if the clinic had billed me correctly.

Others would probably not check their bills too, as the insurance provider would settle the payment.

This may lead to unscrupulous doctors overcharging or charging for items and services not rendered.

This can jack up medical costs and, with higher bills, insurance companies may raise premiums.

This is not unprecedented.

The Ministry of Health found that some clinics had been abusing the Community Health Assist Scheme system to overcharge and over-service patients, and made it mandatory for clinics to provide itemised billing (Three clinics under probe over errant Chas claims; May 10, 2017).

When I asked the Singapore Medical Council and the Ministry of Health why itemised billinghas not been expanded to private medical schemes, both could not provide an answer.

Not satisfied with the opaque billing procedures of private clinics, I then opted for polyclinics. This has not gone well, as it usually takes about three hours before I can see a doctor.

During my last visit, I was told I would have to wait a year for a physiotherapy session at a public hospital for my back pain.

I wonder how much of this is due to more people flocking to public facilities for cheaper treatment because private medical services have become too expensive and beyond the reach of those without wide insurance cover. I can always return to private medical care, but I will still not know if I have been billed correctly.

Health Minister Gan Kim Yong believes zero payment "dilutes the personal responsibility to choose appropriate and necessary care".

Perhaps the problem is not just irresponsible patients but also that doctors are not being checked for overcharging. Mandating itemised and transparent billing for medical services should mitigate that.

Fawziah Selamat (Ms)

A version of this article appeared in the print edition of The Straits Times on March 09, 2018, with the headline 'Itemised bills can reduce ballooning of claims'. Print Edition | Subscribe