Hospital Bills

[Larryst]

I was currently in the hospital recently in Pattaya & Bangkok. I had insurance and it paid most of it. I had to pay the rest no problem. What happens, if a person doesn't have medical insurance or the funds to pay the hospital. What happens then?? Does the hospital write it off or what happens to the patient???

[scubascuba3]

they seem to he able to get the money, they wouldn't let them off just like that, may want money up front

[lopburi3]

Normally he does not receive treatment as without insurance you are asked to pay in advance for known medical treatment - for emergency treatment without such payment you are billed and expected to pay.  That some do a runner is a serious issue for those living here and future travelers with all kinds of fail safe insurance programs being required or mulled over.  In short most hospitals will make arrangements for those without current cash but there is indeed a percentage of write off (accounting for higher prices for everyone). 

[ThailandRyan]

It is why I try and keep my bank accounts flush, and if needed have an emergency CC that has no balance and can be used to pay up to 2 million baht if the need ever arises.  Having insurance is just not enough these days unfortunately.

[sqwakvfr]

I know someone who was asked to put a deposit down before he was admitted to a hospital in BKK.  He had a bad case of food poisoning and spent two nights in a very nice room  The total bill was over 20,000 Baht and a 10,000 charge was placed on his credit card before he was treated.  In the end it was an IV, some meds, blood work and some bland hospital food.  

[ignis]

22 minutes ago, sqwakvfr said:

I know someone who was asked to put a deposit down before he was admitted to a hospital in BKK.  He had a bad case of food poisoning and spent two nights in a very nice room  The total bill was over 20,000 Baht and a 10,000 charge was placed on his credit card before he was treated.  In the end it was an IV, some meds, blood work and some bland hospital food.  

I was taken to Private Hospital ER with a burst Appendix in 2004, after an examination had to pay 70,000 baht up front…

 

Since then always use a Government Hospital [next Village] or Red Cross in BKK, you get the bill after, or if in Hospital for some days then get the bill every day = No up front bills  + have spent total of 5 weeks in Hospital 2 x in Red Cross and 3 x in Sai Noi Government Hospital over the years

[RandiRona]

1 hour ago, ThailandRyan said:

It is why I try and keep my bank accounts flush, and if needed have an emergency CC that has no balance and can be used to pay up to 2 million baht if the need ever arises.  Having insurance is just not enough these days unfortunately.

You wanna do brother a favor and share your account info?? You have a tonne of high availability and disaster recovery so I can take some load off 

[lopburi3]

1 minute ago, ignis said:

Since then always use a Government Hospital [next Village] or Red Cross in BKK, you get the bill after, or if in Hospital for some days then get the bill every day

If you use special channels (selected doctor) at a government hospital you may be charged in advance in my experience.

[Sheryl]

2 hours ago, sqwakvfr said:

I know someone who was asked to put a deposit down before he was admitted to a hospital in BKK.  He had a bad case of food poisoning and spent two nights in a very nice room  The total bill was over 20,000 Baht and a 10,000 charge was placed on his credit card before he was treated.  In the end it was an IV, some meds, blood work and some bland hospital food.  

Common practice in private hospitals to require a deposit unless the patient is insured. (If insured, they will wait to get a "Guarantee of Payment" from the insurer).

[NancyL]

On 4/28/2022 at 11:20 AM, Sheryl said:

Common practice in private hospitals to require a deposit unless the patient is insured. (If insured, they will wait to get a "Guarantee of Payment" from the insurer).

If you're admitted to a private hospital for something urgent, they will want a deposit even if you have insurance.  If you aren't able to make a deposit, then you are referred to a government hospital.  This was my experience when admitted to a private hospital for sepsis, with a high fever.  No time to wait around for "Guarantee of Payment".  Friends have had similar experiences. 

 

I gladly paid it, knowing I had a deductible with the insurance and the amount requested was lower than the deductible.  Let the insurance office at the hospital obtain the "Guarantee of Payment" while I'm getting treatment paid by my deposit.

[Sheryl]

45 minutes ago, NancyL said:

If you're admitted to a private hospital for something urgent, they will want a deposit even if you have insurance.  If you aren't able to make a deposit, then you are referred to a government hospital.  This was my experience when admitted to a private hospital for sepsis, with a high fever.  No time to wait around for "Guarantee of Payment".  Friends have had similar experiences. 

 

I gladly paid it, knowing I had a deductible with the insurance and the amount requested was lower than the deductible.  Let the insurance office at the hospital obtain the "Guarantee of Payment" while I'm getting treatment paid by my deposit.

It depends on how time sensitive the urgency is and how quick to respond your insurance is. A good insurance company will respond within a few hours at most in a true emergency (non-emergency will be days to a week or more and is expected to be arranged prior to admission). Even so, a few hours can be longer than advisable to wait so it is good to have an available balance on your credit card.

 

Also depends how efficient the 3rd party payment office of the hospital is.

 

One needs to be alert to the fact that some staff in such offices will attempt to persuade patients to self-pay and seek reimbursement later in their own, purely to save themselves work. Do nto fall for this as you will then have an uphill battle getting the needed paperwork out of the (already paid) hospital. Thai hospitals are not good at completing required insurance forms (even the so-called "top international" ones) as it is, it is typical for there to have to be multiple submissions as the initial ones are incomplete, and if the hospital has already gotten their money they have no incentive to comnply with insurance documentation requests.

 

Also beware of hospitals that tell you "insurance won't pay" if you have a valid policy that should cover it.  More often than not what has happened is that the hospital has simply not provided the required information or completed the required forms.  Insist on seeing the exchanges between the hospital and the insurance company showing that the hospital has submitted all required information and that nonetheless the insurer has declined payment.

 

Not all hospitals are like this of course, but a surprising number are.

 

In my case, after an accident, I was admitted to the ER, given immediate care there and stabilized awaiting surgery. I was told it would likely take about 4 hours to get the GOP from my insurer and that I could choose to either wait for it before having surgery, or provide a credit card deposit in order to have surgery immediately. As infection was a concern,  I opted for the latter; by the time the surgery was over the GOP had come through (took about 4 hours as predicted - this was on a Sunday) and the hospital then tore up the credit card deposit.

 

So it is indeed wise to have an available balance on a credit card for such cases. But make sure the hospital has first submitted a request for a GOP before you offer upo your card as otherwise they might never do so...self-pay being so much less work for them.

[scubascuba3]

7 minutes ago, Sheryl said:

It depends on how time sensitive the urgency is and how quick to respond your insurance is. A good insurance company will respond within a few hours at most in a true emergency (non-emergency will be days to a week or more and is expected to be arranged prior to admission). Even so, a few hours can be longer than advisable to wait so it is good to have an available balance on your credit card.

 

Also depends how efficient the 3rd party payment office of the hospital is.

 

One needs to be alert to the fact that some staff in such offices will attempt to persuade patients to self-pay and seek reimbursement later in their own, purely to save themselves work. Do nto fall for this as you will then have an uphill battle getting the needed paperwork out of the (already paid) hospital. Thai hospitals are not good at completing required insurance forms (even the so-called "top international" ones) as it is, it is typical for there to have to be multiple submissions as the initial ones are incomplete, and if the hospital has already gotten their money they have no incentive to comnply with insurance documentation requests.

 

Also beware of hospitals that tell you "insurance won't pay" if you have a valid policy that should cover it.  More often than not what has happened is that the hospital has simply not provided the required information or completed the required forms.  Insist on seeing the exchanges between the hospital and the insurance company showing that the hospital has submitted all required information and that nonetheless the insurer has declined payment.

 

Not all hospitals are like this of course, but a surprising number are.

 

In my case, after an accident, I was admitted to the ER, given immediate care there and stabilized awaiting surgery. I was told it would likely take about 4 hours to get the GOP from my insurer and that I could choose to either wait for it before having surgery, or provide a credit card deposit in order to have surgery immediately. As infection was a concern,  I opted for the latter; by the time the surgery was over the GOP had come through (took about 4 hours as predicted - this was on a Sunday) and the hospital then tore up the credit card deposit.

 

So it is indeed wise to have an available balance on a credit card for such cases. But make sure the hospital has first submitted a request for a GOP before you offer upo your card as otherwise they might never do so...self-pay being so much less work for them.

I had a diving accident once and needed to go in a decompression chamber, had travel insurance at the time, I called the insurance company and they agreed it there and then to the Dr, took minutes and in I went

[Chris.B]

If you are a cash payer and they don't know you,  you won't get the treatment unless you pay upfront.  

[lopburi3]

Further thinking believe my post in error.

[userabcd]

"What happens, if a person doesn't have medical insurance or the funds to pay the hospital. What happens then?? Does the hospital write it off or what happens to the patient???"

 

Was it not the reason why the new 300 baht tax is being charged to all visitors to cover the hospital bills of those who do not pay?

[ThailandRyan]

2 hours ago, Chris.B said:

If you are a cash payer and they don't know you,  you won't get the treatment unless you pay upfront.  

Not always true. Daughter had Pnuemonia years ago, took her to Bangkok hospital in Udon Thani, only paid upon her being released after 5 days.  Was then reimbursed by the insurance company (Anthem) which was US based after the fact as the hospital would not accept it without a certificate of guarantee from the insurance company up front at the time of admittance.

[Lemsta69]

On 4/28/2022 at 8:27 AM, lopburi3 said:

Normally he does not receive treatment as without insurance you are asked to pay in advance for known medical treatment - for emergency treatment without such payment you are billed and expected to pay.  That some do a runner is a serious issue for those living here and future travelers with all kinds of fail safe insurance programs being required or mulled over.  In short most hospitals will make arrangements for those without current cash but there is indeed a percentage of write off (accounting for higher prices for everyone). 

I'm gonna go out on a limb there and posit that the amounts they write off are far exceeds by the amounts they overcharge farang in the great government-sanctioned multi-tier pricing system. som nam naa and all that. ????

[lopburi3]

22 minutes ago, Lemsta69 said:

I'm gonna go out on a limb there and posit that the amounts they write off are far exceeds by the amounts they overcharge farang in the great government-sanctioned multi-tier pricing system. som nam naa and all that. ????

Don't really believe this is a good example of unjustified dual pricing.  Thai have lower price because of a free healthcare system - if treatment not in home area they can obtain service at a nominal price - suspect that the actual cost would likely be much closer to the price charged to foreigners.

[Mark Nothing]

The hospital will notify the police who will incarcerate the nonpayer until he coughs up payment.

[Lemsta69]

23 minutes ago, lopburi3 said:

Don't really believe this is a good example of unjustified dual pricing.  Thai have lower price because of a free healthcare system - if treatment not in home area they can obtain service at a nominal price - suspect that the actual cost would likely be much closer to the price charged to foreigners.

until they start means-testing Thais I'll stick to my opinion ????

[lopburi3]

2 minutes ago, Lemsta69 said:

until they start means-testing Thais I'll stick to my opinion ????

Actually that was being done some 20+ years ago when my Thai wife used major government hospital for operation - fee was based on family income.  But there is no means requirement under current system - at most a 30 baht fee if using assigned medical facilities.

[dingdongrb]

5 hours ago, Chris.B said:

If you are a cash payer and they don't know you,  you won't get the treatment unless you pay upfront.  

Not true!

 

I just received a stent and was asked before the procedure if I had insurance. I said I didn't and would be paying cash. Three days later I paid as I was being discharged from the hospital. They didn't even require my passport as they accepted my Thai driver's license.

[lopburi3]

4 minutes ago, dingdongrb said:

Not true!

 

I just received a stent and was asked before the procedure if I had insurance. I said I didn't and would be paying cash. Three days later I paid as I was being discharged from the hospital. They didn't even require my passport as they accepted my Thai driver's license.

Three days later for a stent?  Normally it is next day release in my experience.  But perhaps this was also an emergency procedure and thus a reason for not having the pre payment?  Mine were also done with no prepayment as had 2 hours after stress test indicated serious issues. 

[dingdongrb]

16 minutes ago, lopburi3 said:

Three days later for a stent?  Normally it is next day release in my experience.  But perhaps this was also an emergency procedure and thus a reason for not having the pre payment?  Mine were also done with no prepayment as had 2 hours after stress test indicated serious issues. 

Saturday evening went into the ER and was placed in Cardiac ICU. Sunday, monitored and provided medication to relieve clotting. Monday received stent. Tuesday released from hospital.

 

Seemed reasonable to me and my body.

[Nickelbeer]

4 hours ago, userabcd said:

"What happens, if a person doesn't have medical insurance or the funds to pay the hospital. What happens then?? Does the hospital write it off or what happens to the patient???"

 

Was it not the reason why the new 300 baht tax is being charged to all visitors to cover the hospital bills of those who do not pay?

If that's the case, they ought to give ALL expats the option to pay 300 baht a month and have emergency hospital bills taken care of. The usual lack of thought and logic in Thai planning. Expats are not even an afterthought in their scheme of things.????

[lopburi3]

5 minutes ago, dingdongrb said:

Saturday evening went into the ER and was placed in Cardiac ICU. Sunday, monitored and provided medication to relieve clotting. Monday received stent. Tuesday released from hospital.

 

Seemed reasonable to me and my body.

So you had the same stent and release next day but additional time/care prior to procedure.

[Chris.B]

2 hours ago, Lemsta69 said:

I'm gonna go out on a limb there and posit that the amounts they write off are far exceeds by the amounts they overcharge farang in the great government-sanctioned multi-tier pricing system. som nam naa and all that. ????

There isn't any multi-tier pricing in the private hospitals. You pay the same as a Thai! ????

 

[Chris.B]

On 4/28/2022 at 8:33 AM, ThailandRyan said:

It is why I try and keep my bank accounts flush, and if needed have an emergency CC that has no balance and can be used to pay up to 2 million baht if the need ever arises.  Having insurance is just not enough these days unfortunately.

An emergency credit card with a USD 65,000 limit, that is some limit!! You must be a wealthy man to have such a card?

 

My experience with credit cards is 1) If you don't use them they close them down 2) If you don't use the credit limit they reduce it. Is it not the same in the USA?

 

[Chris.B]

51 minutes ago, dingdongrb said:

Not true!

 

I just received a stent and was asked before the procedure if I had insurance. I said I didn't and would be paying cash. Three days later I paid as I was being discharged from the hospital. They didn't even require my passport as they accepted my Thai driver's license.

I was referring to private hospitals only.

 

[Sheryl]

11 minutes ago, Chris.B said:

 

 

My experience with credit cards is 1) If you don't use them they close them down 2) If you don't use the credit limit they reduce it. Is it not the same in the USA?

 

 

No, it is not.

 

Never heard of either of these things happening.

 

I have never used my full credit limits and they were never reduced, in fact just got one increased.