Payment for hospital bill

[falang74]

Chuay Duay? Chuay Duay?

Major Problems at Bumrungrad. Does anyone know what the standard operating procedure is at Bumrungrad if you can not pay all up front.

Situation:

My daughter who is on the Gold Card in Ubon where she lived until two weeks ago, travelled to Bangkok to move with my wife also on gold card and they were looking for a place to live as I will be studying there starting next month.

My daughter collapsed from and had a major seizure about 100 yards from the emergency room at Bumrungrad. Of course, she was taken there. We didn't think, wait let's try to get her to a government hosital through traffic while she is possibly dying.

Fast forward, I am still in America trying to scrape up a few dollars to send, bye the way for those who don't know......all farang are not rich.......Surpised? Anyways my daughter has since improved over the last week and we had no insurance for Bumrungrad hospital.

We owe over $4,000 U.S. dollars 150,000 baht for her care to date not to mention her care plan which the doctors say will carry on for 2 years.

Finally, the hospital saying my daughter was ready for release said she couldn't leave until we paid. I sent $1,150.00 to them 42,000 baht and then they made my wife swipe our maxed credit card two more times for the difference. Denied!, Denied!!! My wife, stressed from a week of her daughter in I.C.U. with little or no help under pressure agreed to pay the difference in two days. that is today............I was very upset with this but had to try and support her right now.

The fact is I don't have another dime, even with help from family the best I might be able to do, maybe is 40,000 per month with the Baht at 37 plus bank fees for tranfer this is alot. My income is 55,000 per month. That means payoff would take 3 months in the best case scenario. I explained via email and phone too Bumrungrad that I could not pay off the total amount and needed other options. Do you know the response? Call your friends and family and have them put it on their credit cards. I then explained that was how I got the first 42,000 and now what else. They had no further reply. Instead they assault my wife with pressure and subtlle threats, while our daughter is hospitalized and trying to get well.

My wife is under the impression that she will be arrested and jailed if she doesn't pay at worst and at best they won't let my daughter out. I think this is a common thought. Is this the reality? I ask for anyone who has information on this or advice that will help to contact me ASAP? I can't imagine the hospital keeping her and taking up space and increasing our bill when we can't even pay the current amount. Bumrungrad is for me the sour faceed frown in the land of smiles.

A last note: I want to say that the doctors and nurses did a great job helping my daughter and getting her through this time. I am so grateful and truly indebted to them for her health and well being. So, I am not complaining about the health care staff at Bumrungrad but I have a serious problem with the finance department are their lack of compassion during a family trajedy. I think that the name finance should be changed to Payoff for exit department

Why does a huge operation like that not have finance options? A bank is their second largest share holder. Charge me 15% or whatever just give me an option

Aaron

Edited May 6, 2006 by falang74

[Krub]

Hi Aaron,

I am sorry to hear of your daughter's illness and am glad she is recoverring.

I do not have experience with ths hospital in particular but finance departements do not have compassion.

You are lucky they treated her (and well) without asling for guarantees up front (their mistake) and they are trying to make up for it now. Many other hospitals in Thailand (and many other countries including the US) would have turned her away even with the risk to her life.

In Thailand it is about the only way they know how to make sure they will get paid 'something'.

You do not need a reminder that thye are in for the business and to make a profit....

Can you offer some security for a loan ? You are better doing that in the States as the rates in Thailand would be very very high.

Best of luck

[lopburi3]

This was posted as a reply to insurance thread but should be a new thread. I hope someone can help you and provide legal information. Very distressing situation.

[traveldog]

Hi Aaron,

I work at a private hospital in Thailand....and yeah the money thing is a drag. The ball was very much dropped by Bumrumgrad in not assessing the financial situation soooner. Keeping patients against their/parents will is not appropriate and if she is stable you should get her out. Our hospital writes off large amounts of uncollectable bills from Farnangs and Thais that is why prepayment or proof of insurance is usually required for private hospital admissions...again Bumrungrad's fault...unless your wife wasn't clear about your ability to pay???

Advice: You need to contact the Cashier or Payment department and work out a plan. Our hospital would be ammenable to a payment plan as you outlined with interest/penalties-be very specific about your plans to pay off. Unfortunately you are not here and that is probably what is concerning the hospital most.....you could just shine them on...my hospital makes a photo copy of the payee's passport as well as getting address info....Your bill really isn't that large, and since you made a substantial payment I keep thinking they are not understanding your position or payment plan. Maybe there is a language barrier, and you may need to speak with someone in their international department. Be patient, be polite and keep asking for someone superior, maybe eventually the managing director? Good luck. I will be speaking with our Cashier/Insurance people about any suggestions for you as well.

[udon]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

I would try to find out if your passport has been red flagged by immigration before trying to enter Thailand again.

I had an accident 3 yrs ago in bkk and the hospital insisted on keeping my passport until I paid the bill.

I told them that the passport belongs to the Aus gov't.

They rang the Embassy and they confirmed what I said.

Never give up your passport, no matter the circumstances.

Good luck & update us.

[Tywais]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

Good luck & update us.

Whether illegal or not it is common practice for hospitals in Thailand to do this. My wife's sister after giving birth had a 30kB bill and the hospital would not let her leave until paid. The same happened to my wife when she was out of town (different hospital) and had an emergency and I had to transfer some funds to get her out of the hospital.

And it does beggar belief in all these cases.

[falang74]

Hi Aaron,

I work at a private hospital in Thailand....and yeah the money thing is a drag. The ball was very much dropped by Bumrumgrad in not assessing the financial situation soooner. Keeping patients against their/parents will is not appropriate and if she is stable you should get her out. Our hospital writes off large amounts of uncollectable bills from Farnangs and Thais that is why prepayment or proof of insurance is usually required for private hospital admissions...again Bumrungrad's fault...unless your wife wasn't clear about your ability to pay???

Advice: You need to contact the Cashier or Payment department and work out a plan. Our hospital would be ammenable to a payment plan as you outlined with interest/penalties-be very specific about your plans to pay off. Unfortunately you are not here and that is probably what is concerning the hospital most.....you could just shine them on...my hospital makes a photo copy of the payee's passport as well as getting address info....Your bill really isn't that large, and since you made a substantial payment I keep thinking they are not understanding your position or payment plan. Maybe there is a language barrier, and you may need to speak with someone in their international department. Be patient, be polite and keep asking for someone superior, maybe eventually the managing director? Good luck. I will be speaking with our Cashier/Insurance people about any suggestions for you as well.

Traveldog,

Thanks for your information.

As for my wife(pre-natal), and myself (3 weeks ) we were both been treated there while I was in the military and I had always paid the full amount. My daughter is clearly part farang or Luuk Krung. I am sure my wife didn't bother to volunteer the fact that we did not have the means to pay up front, but with your daughter in I.C.U. after a sustained 30 minute seizure you tend to forget such things.

In fact, I did all the things you said except for speak with upper managment. The finance manager I was in contact spoke clear english but after talking on the phone she said she would contact her managers and supply me with options. The options are the one I laid out in my first post. Contact friends and family and borrow it etc. I responded back very politely and said that would not help. I need some way to make payments over 3 to 6 months. No response.....

I understand the failures and dishonesty of others in many ways leads them to try and resolve this issue and I read in the Bumrungrad financial report that they have 93% collection. I just know that with my past payment history and the efforts we were making i.e., letter from Mahidol stating my year long exchange agreement, my apartment contract and address( 1year) and partial payment that we deserved at least the respect of human decency.

My daughter was in I.C.U. my wife under extreme distress and they were hounding her. I told them please let her be, as I was the only one with any means to pay and to allow her to focus on our ill daughter. I was very calm and patient. They willl experience my wrath once I arrive in 30 days.

I am in the process of moving my daughters Baht Tong to GrungThep and once I get on my feet in Bkk will add an emergency policy for my family. I am covered at Sirirat Hosptial as a student at Mahidol.

The problem arises when patient care is based on ability to pay. Someone said earlier that in America I would have a problem. The truth is I wouldn't because my daughter was on state medical and even if we weren't when they check my records I would have been added. The hospital would care for her release us and then hit us with a bill. I would pay it or file bankruptcy. Being me I pay off my debts and do so because it is my responsibilty and I will not become one of the loosers who causes others like my wife to be treated less than humane because I failed to handle my responsibilities.

****** UPDATE*******

I payed the 1,100.00 and my wife promised to pay. We were released and when my wife returned two days later instead of paying 60,000 as she had wrongly promised she handed them 10,000. No assault etc. I guess they saw that instead of fleaing the country we returned to continue to the best of our ability to pay our bill.

This does not change the fact that the hospital failed in it's actions prior to my daughters release.

After I pay off the bill and receive all files regarding my daughters condition I will be done with Bumrungad and will no longer recommend them to others. I know, not even a blip on the radar with the profits they are making through medical tours but good for my soul.

This is to tell you that, obviously the threats were pressure and not real. They took my wifes info, swipped our credit cards and had her sign etc, but other than that they could do nothing. If anyone has information different than this please add to this so others who might find themselves in the position I was in last week can get some information.

Gratefully,

Aaron

[falang74]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

I would try to find out if your passport has been red flagged by immigration before trying to enter Thailand again.

I had an accident 3 yrs ago in bkk and the hospital insisted on keeping my passport until I paid the bill.

I told them that the passport belongs to the Aus gov't.

They rang the Embassy and they confirmed what I said.

Never give up your passport, no matter the circumstances.

Good luck & update us.

Updated-

First, I was not there, I know in my post it is unclear but I was here. If I was there I believe it would have been different all together. I would have made sure to reach the right people and clear up confusion.

It seems to be as you said "Beggars Belief" My entire "Isaan family was terrified" including my wife. Luckily my little girl didn't know the *(&^ that was going on.

Thanks for your support.

Aaron

[falang74]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

Good luck & update us.

Whether illegal or not it is common practice for hospitals in Thailand to do this. My wife's sister after giving birth had a 30kB bill and the hospital would not let her leave until paid. The same happened to my wife when she was out of town (different hospital) and had an emergency and I had to transfer some funds to get her out of the hospital.

And it does beggar belief in all these cases.

How long did they keep her? Or did she come up with the cash? The difference is that they tried that a couple days before my daughters release and I made 1,100.00 U.S. payment 42,000 baht. I then told them it would take time. They said this to my wife, never to me, that she couldn't be released till she paid but then when it came down to it she was released without the money.

I expected this, why would a hospital who is worried about loosing money for care already provided, continue to use hospital resources and facilities on someone who they already expect can't or won't pay. That is backwards logic, or cigol......

I expect most people are not honest about there ability to pay and then when put under pressure do it. This in turn promotes these actions. I am not one of those people, I truly didn't and up to now don't have the means to pay, yet.

Aaron

Aaron

Edited May 9, 2006 by falang74

[traveldog]

Aaron,

Glad to hear your daughter is out. I don't believe you did anything wrong, and the strong arm tactics you and your wife endured are unbelievable. I asked our Accounting execs what would happen here and they said we will try to get as much money as we can,(they also felt that a 10% downpayment was a decent show of good faith!) but ultimately we often write it off....our collection rate isn't nearly as good as you say Bumrumgrad btw. They also agreed that holding your daughter hostage is illegal and would generate a lot of negative publicity-as we see here, so really not worth it to such a large/successful organization....they can threaten but ultimately it's really the hospital who didn't do their job in securing your financial ability to pay. I hope you are planning to make a polite and professional written record of your treatment so that the Bumrungrad staff can learn from their mistakes. I would address or personally deliver it to their managing director. By the way...you may want inquire about some medical insurance if you think you can afford a modest premium for the peace of mind. Good luck and hope your family stays in good health.

[lopburi3]

I have also experienced this kind of treatment at Bumrungrad. And there was no question of payment - they just did not have the bill ready and delayed 5 hours. Then when credit card was used for payment they used a special set up to convert baht to dollars at a very poor exchange rate and bill credit card in USD. Needless to say I will never use that hospital again.

[falang74]

Aaron,

Glad to hear your daughter is out. I don't believe you did anything wrong, and the strong arm tactics you and your wife endured are unbelievable. I asked our Accounting execs what would happen here and they said we will try to get as much money as we can,(they also felt that a 10% downpayment was a decent show of good faith!) but ultimately we often write it off....our collection rate isn't nearly as good as you say Bumrumgrad btw. They also agreed that holding your daughter hostage is illegal and would generate a lot of negative publicity-as we see here, so really not worth it to such a large/successful organization....they can threaten but ultimately it's really the hospital who didn't do their job in securing your financial ability to pay. I hope you are planning to make a polite and professional written record of your treatment so that the Bumrungrad staff can learn from their mistakes. I would address or personally deliver it to their managing director. By the way...you may want inquire about some medical insurance if you think you can afford a modest premium for the peace of mind. Good luck and hope your family stays in good health.

Traveldog, I will do that. I am looking forward to getting back to BKK. Even Bumrungrad can 't change how I feel about Thailand. Thanks for checking up with your department. That explains that the reality is that if you are in my position they can not force you to do anything legally, but they may use coercive measures to extract what they can.

****BloodSuckers********* and I don't mean Phlebotomists.

Best,

Aaron

[Dakhar]

My girlfriend at the time, now my wife, was a witness to an accident.... my accident. I rolled an ATV, and it landed on my head. Not a very good situation.

Any how, she was able call EMS in, they flew me and her out to the hospital. There she recieved a full body scan/MRI. She thought they were being overly cautious.... I mean really she was OK, she was all bloodied up. But it was my blood.

Any how, then she recieved a bill for over 4,000 USD.

I called up the hospital and asked to see the her signed consent forum. They tried to claim that she was hurt and could not sign anything. Then I asked where was she hurt, because according to our records, all tests were negative, and she was just fine......

I told them that she was not paying a penney, and she was not going to be paying for their fancy equipment.

The case was dropped, we never heard from them again.

I do not mind paying for a necessary service.... but that bill was just plain bogus. She was a victim not a patient.

[oopapasan]

I have also experienced this kind of treatment at Bumrungrad. And there was no question of payment - they just did not have the bill ready and delayed 5 hours. Then when credit card was used for payment they used a special set up to convert baht to dollars at a very poor exchange rate and bill credit card in USD. Needless to say I will never use that hospital again.

You can have the bill in baht,all you have to do is ask,Ignorance is bliss.

[Tywais]

I have also experienced this kind of treatment at Bumrungrad. And there was no question of payment - they just did not have the bill ready and delayed 5 hours. Then when credit card was used for payment they used a special set up to convert baht to dollars at a very poor exchange rate and bill credit card in USD. Needless to say I will never use that hospital again.

You can have the bill in baht,all you have to do is ask,Ignorance is bliss.

Need to actually read the posts. He said the bill was in baht but his card was probably in dollars.

[lopburi3]

Yes. The bill was in baht and the charge should have been submitted in baht as every other Visa transaction I have made on that card prior or since has been.

[Tywais]

Yes. The bill was in baht and the charge should have been submitted in baht as every other Visa transaction I have made on that card prior or since has been.

Curious as to why that happened. I went there for cataract surgery and just handed them my Visa card and just a few minutes later the transaction was completed. No delays and no calculations from them (I looked at the bill and it was all in baht). When I got my monthly Visa transaction letter the conversion rate (baht-dollar) was essentially the same as other places - that is, reasonable. Perhaps why others have complained, inconsistancies.

[lopburi3]

This was done in February 2004. Recall others in forum and in press letters complaining about it and it probably ceased. Believe it was an attempt by Bangkok Bank to bypass the "foreign card use" charge that was starting to be made by credit card companies. So they made the profit rather than Visa or western banks. In my case my bank had so such surcharge so the poor exchange rate was very noticeable. As this was not a patient release but a transfer did not notice until patient had recovered at another hospital. The receipt I was provided had faded to blank in less than that time.

[oopapasan]

I have also experienced this kind of treatment at Bumrungrad. And there was no question of payment - they just did not have the bill ready and delayed 5 hours. Then when credit card was used for payment they used a special set up to convert baht to dollars at a very poor exchange rate and bill credit card in USD. Needless to say I will never use that hospital again.

You can have the bill in baht,all you have to do is ask,Ignorance is bliss.

Need to actually read the posts. He said the bill was in baht but his card was probably in dollars.

You get the bill in baht charge to your card and get the visa rate which is better.2 n 2 equals 4

I read it do I have to explain everything?/I do it all the time

[lanny]

Four years ago, I had my gall bladder removed at Bumrungrad. Not exactly an emergency but I went there complaining of what I thought were gas pains and was kept overnight and operated on in the morning. They kept me for 4 days -- claiming they were concerned about my blood sugar level (I amd diabetic) all the time they had me on a glucose IV!!!

When I was ready to leave, the cashier insisted that I pay in full before leaving -- about 130,000 Baht. I explained that I didn't have that much cash or credit card limits but they wouldn't budge. They also threatened to not let me leave. Eventually, I told them I was leaving, regardless of what they said and I would return on the next business day (it was a weekend) to make payment arrangements.

Eventually, I told them I would pay off in two or three installments and they could take it or leave it. They had me sign an agreement of some sort but did not charge interest.

[ricklev]

A couple of days ago I had some dental work done at St. Louis Hospital. I handed the cashier my Mastercard, she processed it and handed me the reciept for my signature. The reciept read; "Please debit my account with the total amount in USD. I acknowledge I have a choice to pay in THB." The exchange rate of 36.61 was on the reciept; about 1 baht below what Mastercard would calculate the exchange at. I didn't feel like arguing about what would only be about 40 baht, or asserting my choice to a cashier that could not speak English, but it but I left feeling slightly annoyed. I wonder if the hospital/merchant gets a cut or a reduction in their percentage charge?

[lopburi3]

That is exactly what happened to me although do not recall any explanation or choice. Thought that they had done away with that as no other merchant seems to use this tactic. I also expect the merchant gets a cut (or reduced charge more likely). That this is done in such a high anxiety setting I find condemnable.

Let me add that is was just a minor incident and not the reason I have low regard for that hospital.

[oopapasan]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

Good luck & update us.

Whether illegal or not it is common practice for hospitals in Thailand to do this. My wife's sister after giving birth had a 30kB bill and the hospital would not let her leave until paid. The same happened to my wife when she was out of town (different hospital) and had an emergency and I had to transfer some funds to get her out of the hospital.

And it does beggar belief in all these cases.

They solved the problem,they make everybody pay up front now.Too many dead beats skipping out on bills making it harder on everybody else.No money no fixee.

[mouse]

I pay by means of the U.S. Military TRICARE system which costs me a $150 annual deductable in additon to 20% of the total bill. Paying any hospital its not a problem for me but, if what I read it true then Bumgard or whatever they are called will never get my business. I do not mind paying for a service but hate high pressure anything or money hungry people such as that.

Did I mention that I had a real hard time adjusting to living in Thailand because of the way I think?

[Cassandra]

Hello Aaron.

It beggars belief that the BH can threaten to keep your daughter if you don't settle your bill.

I hope you can raise the funds to clear the bill.

Surely their action is illegal!

Good luck & update us.

Whether illegal or not it is common practice for hospitals in Thailand to do this. My wife's sister after giving birth had a 30kB bill and the hospital would not let her leave until paid. The same happened to my wife when she was out of town (different hospital) and had an emergency and I had to transfer some funds to get her out of the hospital.

And it does beggar belief in all these cases.

Aaron's case is distressing and I'm sure he has all our sympathy.

However I'm not sure what your problem is.Let me recapitulate.Your wife's sister after giving birth had a bill of Bt 30,000 (a very reasonable $750) and the hospital insisted on payment before she left.So what! That's entirely normal and it's what I would require of your wife's sister if I was the responsible hospital administrator.The case is absolutely not comparable with Aaron's difficulty.

[lopburi3]

Cassandra

30,000 baht is not exactly chicken feed for the average Thai working class family (which this may well have been). In my mind the use of unenforceable threats rather than talking arrangements for payment is the issue. Not that 30k may be only a night on the town for some of us.

[Cassandra]

Cassandra

30,000 baht is not exactly chicken feed for the average Thai working class family (which this may well have been). In my mind the use of unenforceable threats rather than talking arrangements for payment is the issue. Not that 30k may be only a night on the town for some of us.

Point taken Lopburi if indeed ordinary working class family.Nevertheless the two cases are very different.

Aaron's problem was an unforeseen emergency but pregnancy/confinement obviously can be planned for.If Bt 30,000 not affordable surely the issue could have been anticipated well in advance and a move made to a government hospital.So it is difficult to avoid the charge of fecklessness.I'm not defending hospital handling of the situation.Most working class Thais I know -and I know a great many-are very careful not to commit to expenditure they can't afford.But I don't know all the details and thus accept I might be being a bit harsh.

Edited May 14, 2006 by Cassandra

[Tywais]

Cassandra

30,000 baht is not exactly chicken feed for the average Thai working class family (which this may well have been). In my mind the use of unenforceable threats rather than talking arrangements for payment is the issue. Not that 30k may be only a night on the town for some of us.

He has a penchant for not thinking through a post. She makes about 4500 B/month and her husband is unemployed. She was kept there and not allowed to leave for 3-days and this is with a new baby with here now. I would say it qualifies as a significant issue for her. She was under the impression that the costs could be handled through a payment program and of course once in labor, difficult to think about where the money is going to come from for a lump sum payment.

Edited May 14, 2006 by tywais

[Jeff1]

Hello Aaron , Try not to stress to much about it . As they say " you can't get blood out of a stone " You can only pay what you can , when you can . A willingness to pay has to be good enough in a case like this . Nobody is going to jail if you make payments . All hospitals are ruthless when it comes time to pay . You must explain to them that this is how and when you will pay them back . They will be happy to learn that you want to settle the bill , even if it's over time . This will happen in any hospital even in the states .

Be happy that she got top notch care for a decent price and everything is ok . Make your payments and forget about it .

[Sheryl]

It is illegal -- and contrary to the Patients Bill of Rights which was enacted in Thailand in recent years -- for any hospital to keep you or your dependnets in the hospital against your consent, full stop. If anyone attempts to do so, simply depart if physically able to do so (after of course making clear your intention to pay and providing information on where you live/work etc). If it is not physically possible to get out without their help (probably the case with Aaron's daughter) go as high up in the management chain as you have to and also file a complaint with the Thai Ministry of Public Health and your Embassy.

In addition to this unacceptable behavior I have experienced and knwo others who have experienced many other money-grubbing misdeeds at Bumrungrad, including:

- overcharging: items (written in Thai) on bill that should not have been; package price for surgery charged at a higher rate than I was told on admission just 2 days before (and had a written quote for), unnecessary tests, unnecessary drugs, in some cases even unnecessary surgery. I am myself a health professional and physicians at Bumrungrad have told me they are under orders to do certain things to increase revenue, such as not providing prescriptions for filling outside the hospital, etc etc.

Notwithstanding all this, I still sometimes use the hospital and refer others to it -- but only when there is a specific reason to, i.e. the best specialist for what is needed happens to be there. I would not go there for routine things that can be handled esewhere, nor go there if an equally qualified specvialist is available elsewhere.

Aaron -- did you at any point deal with International Relations Dept? I am curious as to whether they would respond better.

All hospiotals encounter situations wherein they have to arrange for post-payment, especially when the admission was an emergency on and the care very costly. I'm sure that there are people at Bumrungrad authorized to approve such an arrangement but they will be high level people, and I find that Thjais are very reluctant to refer matters to their superiors, a cultural thing. They will just tell you something can't be done rather than risk losing face by asking someone else, or risking "annoying" a superior. I encounter this in all sorts of venues (civil servants being thje worst). Soemtimes it is simple laziness as well -- and that phenomena I encounter in my home country as well. One needs to be very firm in insisiting on speaking to a superior...and that person's superior, etc.