Payment On Demand At Hospitals

[Jingthing]

Maybe this is an academic question, maybe it isn't.

When visiting hospitals, you often don't know the total charge until they escort you out to the cashier to pay the bill. I bring lots of cash and have never had a problem, but what happens if the bill is more than you are able to pay on the spot? There is often an ATM there, but in my case there is a 20K baht daily limit, and a bill could easily go over that. Again, what exactly would they do? I know they won't just send a bill like in the west. So what then?

Of course in cases of emergencies you wouldn't even be prepared with lots of cash in your pocket.

-- hold you prisoner in the hospital?

-- call the police?

-- escort you under guard to your bank (what if the bank is closed)?

Any true life experiences, let's hear them!

Edited February 22, 2009 by Jingthing

[Super Hans]

Maybe this is an academic question, maybe it isn't.

When visiting hospitals, you often don't know the total charge until they escort you out to the cashier to pay the bill. I bring lots of cash and have never had a problem, but what happens if the bill is more than you are able to pay on the spot? There is often an ATM there, but in my case there is a 20K baht daily limit, and a bill could easily go over that. Again, what exactly would they do? I know they won't just send a bill like in the west. So what then?

Of course in cases of emergencies you wouldn't even be prepared with lots of cash in your pocket.

-- hold you prisoner in the hospital?

-- escort you under guard to your bank (what if the bank is closed)?

Any true life experiences, let's hear them!

I checked into hospital in phuket once with no money at all - had to phone a mate to come and pay the 2000b deposit. When I checked out, I was given a bill for 7k - told them I was off to the ATM, which was a lie, walked back to my room, got the cash and sauntered back to pay a couple of hours later. I could easily have just not come back - they had no ID and I was checking out of my room that day anyway, so they would not have found me - but I'm the honest sort, so paid in full.

[sassienie]

If one doesn`t pay the doctor`s bill, than they drag the patient back into the hospital, reverse any treatment received and let him/her die if they do not dosh up the dosh with 24 hours.

Sometimes the hospitals can be very flexible when asking for payments.

My wife`s Uncle had a scan at the Ram hospital Chiang Mai.

The doctor said, sorry I`ve some bad news for you. You only have 6 weeks to live.

My wife`s Uncle could not pay the bill, so the hospital gave him another 6 weeks.

[Neeranam]

I've been in many hospitals in Thailand in a previous life - but not this century.

A few I needed treatment and had no money - some let me go and some asked me to come back later. One I went to the toilet and did a runner.

One private one(after falling out a tuk tuk) wheeled me out in a wheelchair to an outside ATM but found it empty. They wouldn't give me my clothes until I had phoned someone to come and pay.

Once I ended up in Samitivej but they sent me to a govt. hospital.

Edited February 22, 2009 by Neeranam

[torrenova]

All outpatient stuff has been pay after with no discussion really.

The baby's birth package was discussed (and hen they tried to rob us later). 50% paid upfront (32k package).

One night inpatient at Pattaya Memorial they asked me if I wanted a private room etc. Bt1500 or so (yes, of course). They asked how I would be paying the next day and I said I would put it on insurance but asked how much. As they said perhaps 5k I said I'd just pay cash and claim it back. Showed them money but don't think it was really necessary.

[GungaDin]

They will ask you for your passport.

Do not give it to them, the passport is not your property, it belongs to your government.

If they want to argue, ask them to ring your embassy to confirm, make sure you speak to the person at the embassy too.

You then have to make arrangements for payment in a few days or whenever you agree to make payment.

[johna]

In the big private hospitals the doctor works independently, and his salary is the fees he charges each patient.

I was once asked on being admitted to a major hospital in BKK if I could pay, and the doctor remarked that if I could not, as the admitting doctor he would have to pay.

There have been cases where patients who could not pay have been held hostage by the hospital in one case a new born baby was “detained” until the parents found the money.

[Syl]

My Thai wife was in hospital a few years back with complications with her pregnancy. three weeks sitting in a bed unable to move because of a low pleasanter and heavy bleeding.

Healthy baby born six weeks early. Wife remarked about the cost of all the treatment to the doctor. Doctor said no problem we can arrange it on finance. Bill came to over 450k. Paid cash. Worth every Baht.

Syl

[H2oDunc]

A friend with no cash had a bad bike accident. Him and TGF taken to private hospital. 1 night there and some first aid and a couple of X rays gave him a bill of 32,000 baht. He was told he needed 3 operations and he was looking at 300-350,000 baht for it to be done there. The guy had nothing! We had a whip round and got 26,000 baht. The English girl working there told the cashier that was all he had and they accepted it as full and final payment. He was then sent to the Government hospital at Nathon and had all the operations. Funnily enough the same surgeon that was going to do the operation at the private hospital did the operation at the Government one. The bill there was around the 30,000 baht region for op and 3 days bed. They did not hassle him for the cash and they let him leave with an agreement to pay the bill off in instalments. It certainly makes you think hard and long about your own medical insurance matters!

[Jimjim]

Anyone ever heard of insurance? It does exist, even in Thailand.

[lazygourmet]

Happened to a friend last year. Not enough cash to pay his (huge) bill at Burumgrad.

They called his consulate (Swiss) which they had to wait for a guarantor back home to lend him funds needed.

That took 2 other nights and he was not able to leave his floor.

I visited him during that time and when we went downstairs for a coffee, a security guy accompanied us.

And yes, of course, they charged him for extra nights...

[Heng]

Ever heard of people who can't afford insurance or choose to waste money on everything else but healthcare until it's too late?

[Gary A]

This should be a warning to the people who live here day to day. No insurance and only a small amount of money. Young people who should be a their peak earnings had they remained in their home country are working here for a subsistence wage. Sooner or later some catastrophe will befall them, then what?

[keestha]

Remember having heard about foreigners being severely injured in a traffic accident, being brought to a hospital and then being stabilized and not really treated, till it became clear if the person had insurance and/or sufficient money to pay the hospital bill.

Does anybody have case stories to confirm this? I could also imagine it might make a difference if you are in say Pattaya or in Nakhon Nowhere.

[Rimmer]

They always teach you in business management that 'anyone can make a sale, but getting paid is the clever part'

[offset]

Insurance is very important everywhere but not everybody is insurable also people with existing conditions have to cover the cost of these conditions themselves and once you are past 70 the cost goes up quite a bit you have to consider if it is viable

[daxbr]

Checked into Samitivej Bangkok. They asked me for a credit card and charged B25000. Upon checkout, the casher came to my room and handed me the bill to pay at Bangkok Bank. I paid in cash the following day the balance of around B75k. One month later, I got a call that they never received the funds. I faxed them the receipt and that settled it.

[Neeranam]

Bamrungrad wouldn't give me my daughter until they had seen the receipt.

[H2oDunc]

Remember having heard about foreigners being severely injured in a traffic accident, being brought to a hospital and then being stabilized and not really treated, till it became clear if the person had insurance and/or sufficient money to pay the hospital bill.

Does anybody have case stories to confirm this? I could also imagine it might make a difference if you are in say Pattaya or in Nakhon Nowhere.

That's basically what they did to my friend. Stabilised him, bandaged him and then Nothing as he told them straight off he had no cash. He had a broken and dislocated toe, broken ankle and dislocated / torn ligaments. The GF had a broken collarbone and cuts and bruises Both very lucky if you can call all that lucky. On the lake road Chawang going towards so Reggae a Thai coming the opposite direction simply came round the bend onto their side of the road and head on. As well as the Hospital bills he has the rental bike to pay for which is a write off and the Thai guy is chasing him for his medical costs and bike costs. An expensive lesson learnt. He was meant to be going to work offshore next week as well.

[astral]

Hospitals will usually give quotes and fixed prices for operation.

[lodesafun]

Samitivej can be ruthless.

[GungaDin]

If anyone has had good treatment at a gov't hosptal, please list the name here.

I've heard good reports about the main military hospital in BKK.

Expats can go there.

[wolfmanjack]

Remember having heard about foreigners being severely injured in a traffic accident, being brought to a hospital and then being stabilized and not really treated, till it became clear if the person had insurance and/or sufficient money to pay the hospital bill.

Does anybody have case stories to confirm this? I could also imagine it might make a difference if you are in say Pattaya or in Nakhon Nowhere.

That's basically what they did to my friend. Stabilised him, bandaged him and then Nothing as he told them straight off he had no cash. He had a broken and dislocated toe, broken ankle and dislocated / torn ligaments. The GF had a broken collarbone and cuts and bruises Both very lucky if you can call all that lucky. On the lake road Chawang going towards so Reggae a Thai coming the opposite direction simply came round the bend onto their side of the road and head on. As well as the Hospital bills he has the rental bike to pay for which is a write off and the Thai guy is chasing him for his medical costs and bike costs. An expensive lesson learnt. He was meant to be going to work offshore next week as well.

32,000 sounds like a lot for just being stabilised. My wife had emergency surgery to have her appendix removed as it was about to burst. They brought in a specialist to do the operation since she was 7 months pregnant at the time and they feared for the baby. This was at a private hospital and involved several days observation in a private room. The bill was only 30,000 baht.

[Hairy]

At Bumrungrad, they've allowed me to have multiple appointments before paying the full bill at the end. One "customer service representative" was rude about it one time, but generally it wasn't a problem. This was not for huge wads of cash, however, and I was a repeat customer.

[camerata]

If you have a credit card and/or are a regular customer based in Thailand there shouldn't be any problem. That's been my experience at Bumrungrad and Samitivej. The only times money has been mentioned before treatment is once at Samitivej when I paid for a 50K operation for someone else and once at Bumrungrad's Laser Surgery Dept (about 9K baht). Both times they estimated the cost and that became a deposit paid by credit card. This is the only reason I keep my Amex credit card with its theoretical "no limit." If I get hit with a monster bill, I'll pay with the card and sort it out with Amex later.

[mizzi39]

This should be a warning to the people who live here day to day. No insurance and only a small amount of money. Young people who should be a their peak earnings had they remained in their home country are working here for a subsistence wage. Sooner or later some catastrophe will befall them, then what?

Thanks for reminding me as to why I gave myself a long extentend "TV holiday" Gary . Many of us "young people" do just fine here. I live here at a fraction of the cost than it costs me to live in the U.S. (married, baby, car, house, etc....) and oh yeah, insurance, which is easy (and cheap) to get if you have a WP and B visa.

Be happy that there is young blood here in the LOS. many of us are decades away from joining the over 60 geriatrics club.

[thaicbr]

I had an motorcycle accident in Nakhom Pathom and was taken to Nakhom Pathom Government Hospital (the accident was pretty much outside it). and can honestly say that the treatment i received was on par with what i would have got in the UK. only thing is no meals, you have to have friends or relatives bring them in (at least thats what happened for me).

I still can't remember the accident or the 3 days previous to it.

I also have a friend (thai) who's sister had a BAD accident and lost a good chunk of her skull. they just recently reconstructed. and it seems a bloody good job. cos she hasn't got a flat head now. OH forgot to mention the Hospital bill was less than 3,000baht for my accident.

Allan

Edited February 25, 2009 by thaicbr

[oevna]

A couple years ago I had an overnight stay at Bangkok Pattaya Hospital for food poisoning. I arrived in extreme pain, and they gave me something that I assume was morphine, which was much appreciated. It was after the morphine took hold that they brought up the topic of payment. Fortunately I had a credit card on me, and they charged it with half of the estimated cost of my treatment (they said it was a high estimate, and the remainder of the cost would likely be somewhat less). The treatment included antibiotics, lab tests, muscle relaxants, IV drip to keep me hydrated, and an overnight stay with meals. They said that I could pay the rest of the bill the next day when the actual cost of my treatment could be accurately figured. As far as the medical treatment went, I felt well taken care of, and my recovery was quick.

Under the effects of the morphine, I really had to struggle to understand what they were explaining to me about the estimated cost and how it would be billed. My head just felt slow and foggy. Just signing the credit card receipt was a challenge. After my head cleared a bit I wondered, was that even legally binding? I was stoned out of my mind! They could've asked me for anything and probably would have just signed on the line.

[gregb]

Technically this is the same problem as if you don't pay your hotel bill. The hotel or hospital is allowed to file a police report and in theory you would be detained trying to leave the country.

Have I ever actually seen this happen? No. But I do know a hotel owner who was going through the process for this until the guy finally backed down and came through with the money. The law is out there for them to use if they want to.

If you leave the country quick under these circumstances, probably nothing would ever happen to you...but then you might not be able to come back. Best just to be honest and not have to worry about whether the hospital is vindictive or not.

[Pakeha]

Brother in law got gut shot and other brother in law rushed him to private hospital for (decent) treatment (so he could actually survive). Hospital refused to treat him until they had proof of funds (e.g. credit card swiped) to pay. They didn't have any on them as they were in quite a rush to get to the hospital after receiving a bullet in the gut! He was seriously bleeding out in their waiting room and they didn't give a sh*t .

Brother in law (not shot) managed to convince them best to treat him and the payment will get sorted. They treated him (reluctantly) and the payment was made after a phone call or two.

I was very dissapointed with this. They would have let him die in their waiting room if we didn't have influencing factors other than a lot of cash on his peson. What serious neglect of the hypocratic oath... or is that the hypocritiic oath?

I mean, seriously, who carries a couple of 100k cash on them???