Professional and regulatory bodies, private hospitals and insurers welcome fee benchmarks

Patients will no longer need to delay treatment while waiting for approval from insurance companies, if they are seeing doctors who charge within the benchmarks. PHOTO: ST FILE

SINGAPORE - The move to publish fee benchmarks for surgery in the private sector has been welcomed by professional and regulatory bodies, as well as private hospitals and insurers, who say that the greater transparency will empower patients and help to tackle rising healthcare costs.

The Singapore Medical Association (SMA), which represents the majority of medical practitioners in both the public and private sectors, said in a statement on Tuesday (Nov 13) that the guidelines will help to promote trust between patients and doctors.

The guidelines will also simplify the process of using health insurance for surgery, said SMA's president, Dr Lee Yik Voon.

Patients will no longer need to delay treatment while waiting for approval from insurance companies, if they are seeing doctors who charge within the benchmarks. They will also have a wider choice of doctors, if they are allowed to consult any doctor who charges within these benchmarks, he added.

The College of Family Physicians Singapore said while the surgical procedures which have been benchmarked are largely not performed by general practitioners (GPs), the guidelines will be useful when referring patients to specialists.

GPs can use the guidelines to anticipate fees and help patients choose an appropriate specialist, said the council's president, Adjunct Assistant Professor Tan Tze Lee.

"After discussion with the specialist, some patients may consult us for an opinion and we can help them to decipher the information given and offer our advice on the need for the procedure, the type of procedure proposed and act as a liaison with the specialist to clarify any doubts," he added.

Private medical group Parkway Pantai, which owns four hospitals here - Mount Elizabeth, Mount Elizabeth Novena, Gleneagles and Parkway East Hospitals - told The Straits Times that the majority of its doctors are already charging within the recommended price ranges.

It was the first private hospital here to publish a price list of common procedures in 2013, said Mr Phua Tien Beng, the chief executive of Parkway Pantai's Singapore Operations Division.

Parkway Pantai has also worked with its specialists to fix their professional fees and it offers over a hundred fixed-price packages to give patients greater certainty over their medical expenses, he added.

Thomson Medical Centre told The Straits Times that it provides patients with the estimated cost of the hospital stay prior to admission and data compiled by the Ministry of Health on average bill sizes show that it has historically kept fees affordable.

"Fee benchmarking will give healthcare providers a reference point to set a fee schedule with competitive rates," said its CEO Mega Shuen.

"Where relevant, information on the fee benchmarks will definitely form part of our financial counselling to our patients, to enable them to make a more informed decision when seeking treatment."

The Life Insurance Association Singapore (LIA Singapore) said the guidelines will give insurers an additional reference point when reviewing if the fees being claimed are "reasonable and customary".

They will also help to mitigate cases of overcharging by providers, empower insurers to detect inflated claims and take an active approach towards claims adjudication, LIA added.

"The fee benchmarks will support efforts to manage overall medical costs by providing an additional source of guidance for Integrated Shield Plan insurers when establishing and working with their panels of preferred healthcare providers," it said.

Insurers are studying how the benchmarks will influence products in a way that is reasonable to other stakeholders, while ensuring that their healthcare protection plans remain sustainable in the long run, said LIA.

Dr Leow Yung Khee, the medical director and head of Group Insurance at Great Eastern Life, said the benchmarks will enable insurers to have a reference point when dealing with some private surgeons who charge exorbitant fees.

However, there is a fear that some doctors who currently charge at the lower end of the fee benchmarks may raise their fees, she added.

"It will take us probably a year to know how all the dollars and cents pan out," said Dr Leow.

Join ST's Telegram channel and get the latest breaking news delivered to you.