Unpaid Hospital Bills

[roo860]

Might be useful.

[Skipalongcassidy]

10 hours ago, richard_smith237 said:

I had a couple of MRI's in the past year... 

For Outpatient stuff (such as imaging etc) - my insurance covers everything, but is self pay and claim back.

 

 

The MRI at Bumrungrad was smoother... the nursing admin badgered me somewhat for payment, but I told them I wanted to pay in one bill, not 3 separate bills (initial consultation, MRI itself, follow up)...  they were ok with that after I'd explained.

 

At Bangkok Hospital (different issue)... they badgered me, I explained my insurance is self pay and claim back etc...  I was asked about 5 times by different staff how I'm going to pay - it seemed that was all they cared about and I started to get irritated,  they then asked for a deposit with my credit card which I refused and got annoyed...  I asked if they were going to do the MRI or should I go else where (not my finest hour by my buttons had be pressed)... 

 

I've been registered and have used both hospitals for well over 15 years and have full payment history.

 

 

It seems more than anything else these private hospitals are primarily concerned with payment, I get that. 

But when we've explained its self pay and we'll pay directly, have been registered for a long time etc it starts to stretch the meaning of 'care'...  (IMO).

 

 

 

 

Sounds like a rant... I recently was hospitalized in Bangkok Hospital in Chiang Mai... when I was admitted I gave them my insurance info (Thai insurance) and signed a paper saying that I would be responsible for paying if insurance did not... no prepayment... no credit card needed.

[jippytum]

Yes. The government hospitial in Banglemung now require you pay in advance for some tests. Blood tests for example. I think the problem of unpaid bills was  foreign workers rather than expats. 

[Old Croc]

16 hours ago, Liquorice said:

The reasoning behind that was simple. You're at more of a risk of having an accident or requiring medical attention in a twelve-month period (the length of stay permitted on an O-A visa) than a tourist averaging a 3 week stay.  There is also no requirement to have a Thai bank account with the O-A visa. If incapacitated or in the event of death, the hospital have no means of recovering the costs, hence they introduced a mandatory Health Insurance policy.

 

Why do you think in 2019, Immigration changed the financial requirements regarding funds in the bank for retirees?
Prior to 2019 the requirement was 800K for 2 months prior to the date of the very first application, and 3 months prior to the date of application thereafter.

In 2019 Immigration issued a new order 548/2562, which now required retirees using the funds method to have 800K in the bank for 2 months prior to the date of application, then maintain that balance of 800K for 3 months after the extension was issued, at which point they could withdraw half the funds, but must maintain a balance of 400K thereafter.

I don't agree with your premise that someone living here long term is more likely to have an accident than a tourist. That can be easily disproven by observing the daily parade of gravel-rashed, limping and bandaged tourists at major hospitals in Phuket. Also, residents are less likely, nor able, to duck an obligation to pay hospital bills than a short stay tourist.

Perhaps you could also explain why that criterion was introduced for O-A retirees and not the numerically higher group of O retirees? Perhaps you could also explain why existing insurance held by many was no longer suitable and instead could only be bought from a small, select group of Thai companies?

 

I believe the changes in keeping funds for a longer period after extension issue was to quell the incidences of short-term borrowing of these funds by applicants unable to meet the financial requirement themselves.

 

[Old Croc]

@Liquorice

This from a link another member posted. The government admitting the unpaid medical bills were from tourists:

 

FOREIGN TOURISTS failed to pay a combined Bt300 million in medical bills after receiving treatment in state hospitals last year, prompting the government to set up “claim centres” to collect what’s due.

“These problems mostly hit tourist cities,” Health Service Support Department (HSSD) director-general Dr Nattawuth Prasertsiripong said last week.
 

[sikishrory]

I think a bigger issue is hospitals illegally detaining people.

I see about one of these stories every few weeks.

One I read a couple of days ago: Guy being detained in Phuket hospital, medicated, not allowed access to his phone, not allowed to leave until bill (around ฿ 30,000) paid. However the bill increases each day which is a bit of a catch 22.

He was actually reported to police as missing. Of course since he is not allowed phone access he is going to be unreachable (missing) by family and friends.

I used to visit the wards regularly to have a procedure done and they are locked. To open the door the nurse needs to touch her bracelet to a hidden point inside the wall next to the door to unlock it.

[Old Croc]

11 hours ago, richard_smith237 said:

I just want to point out at this time that the medical burden of tourists on Thailands medical industry (i.e. cost of unpaid bills) is 300,000 Million Baht a year.

You probably should amend this figure to match the link you posted. (300 million).  

[Mike Lister]

Poster @Liquorice, in which part of the country is the hospital that you work in, please?

[sandyf]

On 1/25/2024 at 8:05 AM, Mike Lister said:

I had five days in hospital in November and had to leave a deposit and a credit card number before hand, my experience in Bangkok,

I have only been in hospital once, back in 2003 I had 2 days in pattaya memorial following a fall which resulted in broken ribs.

They took my passport on admission for admin but although I had insurance they weren't interested and I had to  pay in cash before getting passport back.

[sandyf]

19 hours ago, scubascuba3 said:

Problem is ambulance can take you to the most expensive hospital where they get paid the most and then that hospital will milk it for all they can, if that person has good insurance then fine

Depends on who is in the ambulance. In the absence of anything else Thais will normally be taken to the nearest government hospital and foreigners to a private hospital.

Friend of mine had a heart attack and his wife called the ambulance, he came round in the ambulance and told the driver to take him home. The driver did what he was told and friend died a few days later.

[Old Croc]

1 minute ago, sandyf said:

Depends on who is in the ambulance. In the absence of anything else Thais will normally be taken to the nearest government hospital and foreigners to a private hospital.

Friend of mine had a heart attack and his wife called the ambulance, he came round in the ambulance and told the driver to take him home. The driver did what he was told and friend died a few days later.

In my only ambulance trip ever, I was taken straight to BHP passing the major public hospital on the way. 

 

Some people just don't want to be helped. I lost a close friend a few months ago after he refused treatment that may have prolonged his life. He didn't want to be a financial burden on his family.

[Mike Lister]

The problem is clearly in the Government Hospital sector but it remains very unclear who is to blame. Resident Expats, tourists or foreign nationals from neighboring countries are all candidates. Despite one post stating that local expats were mostly to blame for unpaid bills at one particular hospital, there is insufficient evidence or data to suggest that is the cause nationwide. I recall the news article about the government hospital in Phuket years ago which very firmly cited the more than 150,000 construction, services and fisheries workers from Myanmar and Cambodia as the main case. Logically, most western tourists and western expats are more likely to have health insurance hence a 300 millions baht bill from those sectors alone, seems improbable.

 

We need more and better data to conclude, this I think.

[jippytum]

2 hours ago, Skipalongcassidy said:

Sounds like a rant... I recently was hospitalized in Bangkok Hospital in Chiang Mai... when I was admitted I gave them my insurance info (Thai insurance) and signed a paper saying that I would be responsible for paying if insurance did not... no prepayment... no credit card needed.

I recently had an op at Bangkok Pattaya hosp.  July 2023. I have longstanding insurance but they required deposit of 250,000 baht. I gave bankers draft that was returned after insurance settled. 

[sandyf]

4 minutes ago, Old Croc said:

Some people just don't want to be helped. I lost a close friend a few months ago after he refused treatment that may have prolonged his life. He didn't want to be a financial burden on his family.

Quite. My friend had said if anything major happened he would  pull the plug, didn't see any point in living here as an insolvent, possibly incapacitated.

[J Branche]

So I see this issue is unpaid bills. Hospitals possibly have difficulty receiving payment from foreign insurance companies.  Tourist who visit with No insurance.

 

I have trip coming up and a stopover visa has a charge for about 140 baht or $4 USD for a minimal insurance policy.

 

This sounds very reasonable and could help reduce the potential payment issues and delays in payment from foreign insurance companies.  Just a thought.

[Liquorice]

1 hour ago, Mike Lister said:

Resident Expats, tourists or foreign nationals from neighboring countries are all candidates. Despite one post stating that local expats were mostly to blame for unpaid bills at one particular hospital, there is insufficient evidence or data to suggest that is the cause nationwide. I recall the news article about the government hospital in Phuket years ago which very firmly cited the more than 150,000 construction, services and fisheries workers from Myanmar and Cambodia as the main case.

They to are foreigners (aliens) as far as Thailand is concerned.

 

1 hour ago, Mike Lister said:

Logically, most western tourists and western expats are more likely to have health insurance hence a 300 millions baht bill from those sectors alone, seems improbable.

Very few tourists actually take out any Insurance cover. Accidents happen to others, never to themselves.
Then there is the situation where the hospital won't deal directly with foreign Insurers.

This happened to me once. I had to settle the bill in cash, and the Insurer reimbursed me.
I do wonder what happens if the patient can't afford to settle the bill in cash.

 

The Thai government run a scheme known as the 'Health Insurance for Foreigners' which prior to 2014 many foreigners signed up for.
You had, and paid for a full medical check, then an annual fee, the total cost being less than 3,000 BHT.

You received a photo card similar to a driving licence, which you just presented to any government hospital.

Around 2015, the hospitals discovered, due to some ambiguous wording, the scheme was specifically meant for Lao, Cambodian and Myanmar workers and not for all foreigners.

 

Such a scheme for all long term foreigners would go a long way to solving unpaid hospital bills.

I don't think many foreigners would object, in fact welcome such a scheme.

Imaging the revenue if such a policy only cost 1,000 BHT a month.

I discussed this at length at my hospital, and they are in total agreement.

A proposal was put forward to the government, but nothing ever materialised from it.

[lopburi3]

1 hour ago, J Branche said:

So I see this issue is unpaid bills. Hospitals possibly have difficulty receiving payment from foreign insurance companies.  Tourist who visit with No insurance.

 

I have trip coming up and a stopover visa has a charge for about 140 baht or $4 USD for a minimal insurance policy.

 

This sounds very reasonable and could help reduce the potential payment issues and delays in payment from foreign insurance companies.  Just a thought.

One issue, from years of reports here, seems to be that even those with such insurance get injured doing things that the insurance does not cover.  Check the go fund me pages for just a fraction of these people.  

[richard_smith237]

4 hours ago, Skipalongcassidy said:

14 hours ago, richard_smith237 said:

I had a couple of MRI's in the past year... 

For Outpatient stuff (such as imaging etc) - my insurance covers everything, but is self pay and claim back.

 

 

The MRI at Bumrungrad was smoother... the nursing admin badgered me somewhat for payment, but I told them I wanted to pay in one bill, not 3 separate bills (initial consultation, MRI itself, follow up)...  they were ok with that after I'd explained.

 

At Bangkok Hospital (different issue)... they badgered me, I explained my insurance is self pay and claim back etc...  I was asked about 5 times by different staff how I'm going to pay - it seemed that was all they cared about and I started to get irritated,  they then asked for a deposit with my credit card which I refused and got annoyed...  I asked if they were going to do the MRI or should I go else where (not my finest hour by my buttons had be pressed)... 

 

I've been registered and have used both hospitals for well over 15 years and have full payment history.

 

 

It seems more than anything else these private hospitals are primarily concerned with payment, I get that. 

But when we've explained its self pay and we'll pay directly, have been registered for a long time etc it starts to stretch the meaning of 'care'...  (IMO).

 

 

 

 

Expand  

Sounds like a rant... I recently was hospitalized in Bangkok Hospital in Chiang Mai... when I was admitted I gave them my insurance info (Thai insurance) and signed a paper saying that I would be responsible for paying if insurance did not... no prepayment... no credit card needed.

 

'Sounds like' an 'its never happened to me comment'... Well done...  

 

 

 

 

 

 

 

[richard_smith237]

Regarding the payment issue... 

 

I had in-patient treatment pre-authorised by April International (I was in hospital over night - the Bill was 130,000 baht).

 

About a month later I received a letter from Bumrungrad telling me April refused to pay the claim. 

I contacted April who informed me that it was due to a 'pre-existing condition' - they sent me scanned copies of my Dr's notes.

 

I'd had a kidney stone about 7 years earlier, and then about 4.5 years before the treatment there was a Dr's comment in my medical noes after I'd had routine medical stating that a previous kidney stone was no longer present and must have passed.

April had a moratorium of 5 years on pre-existing conditions and classified this as a pre-existing condition because there was a comment about a kidney stone it in my notes, even though the comment was referring to the absence rather than the presence of a stone.

I objected, pushed back against April who simply continued to reject the claim. 

Meanwhile I was receiving letters from Bumrungrad stating they'd start legal action if I didn't pay.

 

Ultimately, I paid because I have to travel regularly to work and didn't want any potential travel complications.

I cancelled April Insurance for my family and I and have never considered them since. 

 

An additional facet of this: IF April had rejected the claim from the onset, I would have sought cheaper treatment (lithotripsy - which didn't work anyway and I still have the stone years later, its now bigger).

 

 

 

[richard_smith237]

18 minutes ago, lopburi3 said:

One issue, from years of reports here, seems to be that even those with such insurance get injured doing things that the insurance does not cover.  Check the go fund me pages for just a fraction of these people.  

 

Very much so... Drunk and unlicenced tourists getting into a motorcycle accident is one of the common ones.

 

I can completely understand the insurance companies rejecting the claim in these examples...  BUT, there also needs to be a solution. 

A 'National insurance' system for emergencies (non-elective treatment) that covers foreigners would make good sense.

- Pay 'insurance cover' on entry if visa exempt.

- Prove 'insurance cover' when applying for a visa (or buy it at that point).

There will of course be gaps, but most issues will be covered this way.

[soyaleman]

I have national and private insurance coverage in Germany but judging from all the inputs here, there is much to learn and be mindful of when unwell on foreign soil.

 

Very helpful and educational. Thank you.

[Ralf001]

3 hours ago, jippytum said:

I recently had an op at Bangkok Pattaya hosp.  July 2023. I have longstanding insurance but they required deposit of 250,000 baht. I gave bankers draft that was returned after insurance settled. 

 

Bangkok Jomtien Hospital same.

Jan 2023, Self admitted, gave them my insurance details but when it was found my condition required ICU they wanted a  chunky deposit upfront.

[LarryLEB]

16 hours ago, richard_smith237 said:

I just want to point out at this time that the medical burden of tourists on Thailands medical industry (i.e. cost of unpaid bills) is 300,000 Million Baht a year....   which is 1.5% of the income tourists bring to the medical industry which is 24 Billion Baht year.

 

So.. if foreigners stopped coming to Thailand, Thailands medical industry would be 23.7 Billion Baht per year worse off... 

 

 

 

At today's rate of exchange, 300,000 Million Baht equals 8.4 BILLION U.S. DOLLARS.  I suspect that your figure is incorrect. 

[n00dle]

Personal experience has proven that there is no care without payment guarantee, at least as an inpatient.

Outpatients could skip a bill, but only receive medication after paying. 

 

Public and private hospitals are exactly the same in this regard --  You pay then you get your drugs. 

Anyone that does not understand this, has never experienced healthcare in Thailand.

[n00dle]

16 hours ago, richard_smith237 said:

I just want to point out at this time that the medical burden of tourists on Thailands medical industry (i.e. cost of unpaid bills) is 300,000 Million Baht a year....   which is 1.5% of the income tourists bring to the medical industry which is 24 Billion Baht year.

 

So.. if foreigners stopped coming to Thailand, Thailands medical industry would be 23.7 Billion Baht per year worse off... 

 

 

Think you need to check your numbers mate,

[Photoguy21]

Why not set up reciprocal agreements between countries? That way payment would not be an issue.

[lopburi3]

5 minutes ago, n00dle said:

Personal experience has proven that there is no care without payment guarantee, at least as an inpatient.

Outpatients could skip a bill, but only receive medication after paying. 

 

Public and private hospitals are exactly the same in this regard --  You pay then you get your drugs. 

Anyone that does not understand this, has never experienced healthcare in Thailand.

We are not talking out-patient drugs however.  Hospitals of any type are required to provide emergency treatment under current laws.  This can easily turn into inpatient stay and such stays can become very expensive (million baht and more often if ICU care required for period of time).  Not everyone will have the funds to pay and others will default on payment.  So yes, there is a problem as in any pay for service medical country (or any business for that matter).   

[richard_smith237]

18 minutes ago, n00dle said:

Think you need to check your numbers mate,

 

Correct...  I was very slightly off....

 

300,000,000 of 24,000,000,000 is actually 1.25% not 1.5%... 

 

And I used the estimate for 2022... 

 

If using the estimate for 2024, then the Burden of unpaid medical bills of foreign tourist to Thailand is actually 1% of the value to the medical industry of Tourism to Thailand.

 

 

 

 

https://www.nationthailand.com/in-focus/30365540

https://www.statista.com/statistics/1311335/thailand-market-value-of-medical-tourism/

 

[lopburi3]

1 minute ago, Photoguy21 said:

Why not set up reciprocal agreements between countries? That way payment would not be an issue.

Many countries do not pay for medical service - it is a private service.

[Photoguy21]

Just now, lopburi3 said:

Many countries do not pay for medical service - it is a private service.

True but many do