Thai Hospital Billing To Us Insurance?

[Johpa]

My wife recently returned to Thailand to visit the family and it appears she will need some surgery. Our US based health insurance will cover what little they would cover if it occured in the US, but I fear that if we involve the US health insurance company directly into billing matters that the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy. Anyone have experience in these matters? I am leaning towards paying up front and then hoping the US insurance company will at least apply the payments towards my deductible for the year. Any thoughts?

[Thanyaburi Mac]

My wife recently returned to Thailand to visit the family and it appears she will need some surgery. Our US based health insurance will cover what little they would cover if it occured in the US, but I fear that if we involve the US health insurance company directly into billing matters that the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy. Anyone have experience in these matters? I am leaning towards paying up front and then hoping the US insurance company will at least apply the payments towards my deductible for the year. Any thoughts?

The latter is what I do and have done in the past.  Just charge the bill to my U.S. VISA or MasterCard and send in the bills to my U.S. based healh insurance company.  Have had zero problems with this method over lots of years.  For drugs I pay cash and send in the bills at the end of the year, not a large sum so saves on paperwork.

FYI, just had a baht 109K tab at Vibhavadi Hospital for gallstones & gallbladder removal, two nights stay, will send that bill in this week.  

FYI, my VISA card charges 3% "foreign exchange" ripoff, the MasterCard only a 1% ripoff, so I used the MC.  I'll print out the MC bill off their web site and hope to get back the final $$ amount of $3,341.

Mac

[rak sa_ngop]

the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy.

More like a multi-tier pricing policy! I recently had a stay in hospital and have paid various bills in cash, credit card and direct insurance company billing.

It's a bit difficult to compare apples with apples, but it seemed that bills I paid for in cash were the best 'value' whereas credit card bills were a bit more expensive (also make sure you pay in baht not the CC home currency) and finally direct billing bills were the highest. However if the bills can be paid directly by the insurance company this higher bill should not cost the patient.

If you pay the bills yourself I would therefore recommend paying cash and saving the credit card service charges (although maybe you can claim these back as the previous post suggests).

[lopburi3]

In most cases only the most expensive or those associated with religious organizations would appear as options for direct billing. Blue Cross only lists a handful of the Bangkok hospitals as associated (which does not mean they would automatically accept direct billing in my understanding).

Most hospitals also offer discount cards which often provide 10% or more off which probably would not be available with direct billing.

As said hospitals seem to use the "bill in foreign currency" at a very poor exchange rate. If her family can pay cash and you transfer funds to them (before or after) it would probably save in card/exchange loss. It only take a matter of hours to make a SWIFT wire transfer into a Thai account from the US.

[Johpa]

Paying for the procedure in baat is no problem. Our insurance is with one of the "Big Blues" in the US, and the hospital she will be at in Thailand is an approved hospital. But she was quoted the "locals" price in baat and I fear if we ask our insurance company to get involved they will be quoted a Farang price which will be at least twice as much. Between the deductible and the co-pays, I would end up paying more out of pocket if they were to increase the price too much.

[pgrin]

My wife recently returned to Thailand to visit the family and it appears she will need some surgery. Our US based health insurance will cover what little they would cover if it occured in the US, but I fear that if we involve the US health insurance company directly into billing matters that the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy. Anyone have experience in these matters? I am leaning towards paying up front and then hoping the US insurance company will at least apply the payments towards my deductible for the year. Any thoughts?

Here is my experience:

1)Paid with credit card upfront

2)Filled out this form The BlueCard Worldwide International Claim Form

3)Checked off box saying I had already paid and wanted direct reimbursement and included my Swift number for a wire transfer to my checking account.

4)Mailed in form with copies of all bills

5)1 month later received wire transfer for 80%(my plan pays 80% up to $5000.00)

P

[pgrin]

My wife recently returned to Thailand to visit the family and it appears she will need some surgery. Our US based health insurance will cover what little they would cover if it occured in the US, but I fear that if we involve the US health insurance company directly into billing matters that the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy. Anyone have experience in these matters? I am leaning towards paying up front and then hoping the US insurance company will at least apply the payments towards my deductible for the year. Any thoughts?

Here is my experience:

1)Paid with credit card upfront

2)Filled out this form The BlueCard Worldwide International Claim Form

3)Checked off box saying I had already paid and wanted direct reimbursement and included my Swift number for a wire transfer to my checking account.

4)Mailed in form with copies of all bills

5)1 month later received wire transfer for 80%(my plan pays 80% up to $5000.00)

P

I forgot to add. My situation was an emergency procedure( motorcycle crash). If your wife's procedure is non-emergent it is very important to get pre approval or the claim may be denied.

P

[lopburi3]

I do not believe pre approval is required for hospital admittance outside the USA. I know it is not for fepblue.

[PeaceBlondie]

Likewise, I pay in cash, baht, and then get reimbursed by my carrier in the USA, which so far has paid off handsomely, as if one clerk says to the other clerk, "I cannot believe how incredibly cheap the prices are in Thailand; I won't even disallow these items."

[think_too_mut]

My wife recently returned to Thailand to visit the family and it appears she will need some surgery. Our US based health insurance will cover what little they would cover if it occured in the US, but I fear that if we involve the US health insurance company directly into billing matters that the cost will go up as the Thai hospital will then charge, well you know the old Thai two-tier pricing policy. Anyone have experience in these matters? I am leaning towards paying up front and then hoping the US insurance company will at least apply the payments towards my deductible for the year. Any thoughts?

I have US insurance that cover pretty much everything, including dental.

They say direct billing is possible outside US but it has to be pre-arranged for each patient separately.

No way BKK hospital could rip them off as they know the prices already.

I asked at Bumrungrad and Samitivej, there is a form that has to be faxed to the insurance company and they can fix it. Since it is never kind of money I would not have on me or credit card I just found it too complicated and unnecessary.

Whatever (exch) rate hospital applies makes no diff to me as insurance acepts the entire bill and refunds me cash into my Oz account or cheque.

Since the bills are peanuts, I accumulate them and claim once a year.

For over 3 years, the baby has consumed not more than 15K baht at Samitivej for the entire period. Like 5K a year for vaccinations and regular checkups.

[Johpa]

No way BKK hospital could rip them off as they know the prices already.

I am sure they know the prices charged to ex-pats, but I really doubt they know the prices charged to locals. I am not saying that the Thai hospitals would try to rip off the US insurance companies and I am certain that the cost would still be a fraction of the cost for the same procedure performed in the US. But even a doubling of the gross fee would triple my out of pocket expenses after the deductible.

[lopburi3]

I do not believe there is a multi price system for private hospitals. Most publish basic prices and have even seen Thai insurance company price lists for the various hospital (room costs). There might be more room for negotiations for a Thai or expat paying cash. There probably would be no chance with direct billing for reductions.

Where I have seen different prices is government hospital room charges; but this was based on income.