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Posted (edited)

I developed an abcess (chest area) and everything I had done haven't helped to get rid of the trapped puss. So I contacted my insurance to get a treatment in any hospital they choose. I was informed that everything will be covered and hospital will be informed that payment is guaranteed. I was admitted to a surgery clinic at Bangkok Hospital (Soi Phetchaburi 47) and I was examined by doctor. I was already lying on a surgery table when the first scam tactic was used. I was shown a paper (attached) to sign with a sum of 17 300 bath (something called fly-in package) and informed that it's not fully covered by the insurance (first mention of guaranteed payment of 15 000 bath from thai branch of insurance company). I refused to sign as I was not in pain and told them to solve the situation with insurance branch. I was sent out from surgery table back to waiting room. I immediately contacted my insurance company and they were a bit puzzled that the sum has raised but assured me that I would be fully covered and they would manage it with thai insurance branch. 

They let me wait for 2 hours and after they inform me that they still couldn't see approval and started to blame my insurance company. Once again calling my insurance and I am informed that budget was increased & approved to 18 000 just 4 minutes after my first call and they couldn't understand why hospital is doing nothing to contact them. I started to get <deleted> and asked for the hospital insurance agent that is dealing with my insurance. Surprisingly they found excuse that he is on break/toilet. I immediately told them that they charge 10x more than government hospital and they can't even negotiate with insurance using a phone call. I asked for breakdown of payment and I asked them to do the surgery for 15 000 (mentioned before) or I leave hospital. Waiting another hour, talked to several nurses and they only handed me phone call to hospital insurance agent which was useless. At that time I was decided that I didn't want any treatment from the hospital and I only waited there for the price breakdown. They couldn't provide it and I left the waiting room. Suddenly the nurse rushed to me with the breakdown. When I saw the breakdown it was very vague. Asked them again do it for 15 000 or I leave (in corridor). They still tried to persuade me to wait more. I went out and almost hailed a taxi when a lady manager with 5 nurses started to catch me and explain me situation (another tactic to make me wait more). It was the first time I spoke to manager and I asked what is the amount that I am covered. None of the nurses wanted to mention sum of 15 000 and they were all looking at each other not to screw in front of manager. Suddenly I got answer from manager that I am covered around 15 000 thb. I politely told them don't scam me, there is no "around", there is only maximum. They tried to get my phone number but I refused with a reply that for this poor customer service this hospital doesn't deserve the money. I took the first taxi and they knew they screwed up. In 30 minutes I got a call that all is approved and when do I want the treatment. However, I refused cause I simply do not trust them anymore.

 

Now I asked my insurance company for another hospital which I hope will have better customer service. 

 

TLDR: All hospital staff is fully aware that price inflation scam is going on. They inflate the price and try to get a signature on a surgery table in case insurance will refuse to cover it fully.

 

 

 

 

 

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Edited by xhruso00
added location of abcess
Posted

This IS Thailand my friend...LOS land of scams...little honesty or integrity IMHO.

 

Learn to embrace the scam culture and deal with it constantly...or leave it...as I have.  ☺

Posted

Normal mess, confusion and incompetence at the big private hospitals here and at the Thai branches of insurance companies. 

"They charge10x more than government hospital and they can't even negotiate with insurance using a phone call" 

Combined with rudeness and dishonesty towards the customer. This is also normal at the big private hospitals here. 

 

But you missed the real fun.  If you are lying in the cath lab, waiting for a heart catheter to open up your blocked coronary arteries so your heart (and you) won't die, and then they start these negotiations... On a Friday night, when your main insurance is represented by a call center agent who tells you to call back on Monday...

 

  • Like 1
Posted
10 hours ago, xhruso00 said:

So I contacted my insurance to get a treatment in any hospital they choose. I was informed that everything will be covered and hospital will be informed that payment is guaranteed.

So I take it that your insurance company conveniently omitted to inform you, for their own nefarious reasons, that you and the hospital would, in all probability, need to provide them with a completed pre-approval form before they were prepared to cover the cost of your treatment?

 

An example of this hallowed form (which you should, hopefully, be able to download from your insurer's website) can be viewed by clicking on the following link:-

 

https://www.lumahealth.com/wp-content/uploads/2017/09/Luma-Pre-Approval-Form.pdf

 

Without this form you will, in all probability, find yourself jumping from the frying pan into the fire as regards any alternative hospital which your insurers may choose to suggest to you!

 

Posted
34 minutes ago, OJAS said:

So I take it that your insurance company conveniently omitted to inform you, for their own nefarious reasons, that you and the hospital would, in all probability, need to provide them with a completed pre-approval form before they were prepared to cover the cost of your treatment?

 

An example of this hallowed form (which you should, hopefully, be able to download from your insurer's website) can be viewed by clicking on the following link:-

 

https://www.lumahealth.com/wp-content/uploads/2017/09/Luma-Pre-Approval-Form.pdf

 

Without this form you will, in all probability, find yourself jumping from the frying pan into the fire as regards any alternative hospital which your insurers may choose to suggest to you!

 

 

I informed insurance company that I need abcess treatment (open it & drain it). So the pre-approval for treatment of this was already in place with a budget of 15 000. My self-diagnosis was confirmed by the doctor who examined me. Then the price inflation scam occurred. I have no idea why the hospital refused to talk to insurance agents and did everything to "make me sign"

 

Posted
24 minutes ago, BritManToo said:

Probably cost under 1,000bht at a government hospital.

And the waiting around wouldn't have been any longer.

Absolutely agree. I had same experience but finally the insurance Company paid all the scam. Shame of these private hospitals, Trying the Scam lying on the surgery’s table and funny to read the amount of medication and home’s medication.

  • Like 1
Posted

Today I got treatment at Samitivej hospital which was suggested by insurance company with a total damage of 3400 THB. 

When I saw the cost I was outraged at Bangkok Hospital and immediately took taxi and made a scene in surgery department, asked all the names who got involved in this price inflation scam and told my story to duty manager.

 

I critisized that they refused the treatment for 15000 THB and let me wait and did everything that I urge my insurance company to extract money.

 

What should I do that it can help other people in future? Police report (if yes where)? Talk to media (is there punishement for damaging reputation)?

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  • Haha 1
Posted (edited)

I don't understand your complaint, Samitivej is a top tier private hospital, THB 3,346 sounds good to me, if you wanted something cheaper you should have gone to somewhere less well regarded. A physicians fee of 1,500, meds at 400, plus supplies....the hospital need to make a profit too you know. 

Edited by saengd
Posted
22 minutes ago, saengd said:

I don't understand your complaint, Samitivej is a top tier private hospital, THB 3,346 sounds good to me, if you wanted something cheaper you should have gone to somewhere less well regarded. A physicians fee of 1,500, meds at 400, plus supplies....the hospital need to make a profit too you know. 

I have problem with the price inflation scam at Bangkok Hospital (not Samitivej). They refused to touch me if i don't sign a waiver for 17 300 THB. I have 0 complain about Samitivej.

  • Like 1
Posted

1. This is not a police matter. No law has been broken.

 

2. There are very strict anti-defamation laws in Thailand.  For which reason thread now closed.

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