Fee 10000$ per day, no acceptable move from hospital.Help!

[mamgo]

Hi! Please help by advice! I entry to Burmrugrad yestarday for delivery which price is ok for us. After delivery baby was need nicu and price become 10000 usd per day. We try to ask move our baby to another hospital but doctpr prohibit it. We can not pay that money as they want for 10-15 days.Do we have right to move to another hospital? How?

[Sheryl]

Yes, you have a right to change hospitals IF the baby can safely be moved. Is the baby on a ventilator? As that might make it risky to move him/her.

The best option in terms of facilities, cost and distance would probably be Chulalonghorn Hospital, a government hospital.

However I don't think you have correctly understood re the cost. It is not US$10,000 a day just for being in the NICU.

NICU charge for room + nursing at Bumrungrad is about 12,000 baht. Of course medications, doctor fees, special equipment are in addition to this it still cannot possibly reach anything near the amount you say.

[mamgo]

Thank you very much for reply. Yes, baby is under ventilator in nicu and doctor said its dangerous to move to another hospital. I saw updated bills today afternoon. Nicu 12000, doctor fee 18000, medication 77000 etc. For 12 hours about 230 000 bahts. Now propably more. If they will not allow change hospital what can happen with us then? Go prison? Lost child?

[mamgo]

Please see the file attached. Its per one day.

[fatdrunkandstupid]

Sheryl...looks like this guy is genuine...

What can be done to help.

He is facing a 3 million baht plus bill for a 15 day stay...

[fatdrunkandstupid]

I would ask for an itemised list of all of the medications and medical supplies that are claimed to be used. 150,000 THB a day on meds and consumables seems nothing short of extortion. I am sure that Sheryl will correct me if I am wrong...

[mamgo]

Also I want to make sign that we can not pay anymore and have responcibility of this case. We want have abidence we informed them about our statement. Hospital did not allow it. We can not pay but must accept continue treatment. What to do in this case?

[mamgo]

When we entry hospital I was sure we can pay and if price become impossible how to exit it?

[Jingthing]

The bill is dated APRIL 1.

[mamgo]

Jingthing yes, like 1 april joke. But not joke so much. Why we can not escape hospital when still safe? I know its difficult to entry without money but we can not exit. We dont have property for sale too.

[Jingthing]

Jingthing yes, like 1 april joke. But not joke so much. Why we can not escape hospital when still safe? I know its difficult to entry without money but we can not exit. We dont have property for sale too.

I am so sorry as you say this is not an April fool's joke. I was hoping that it was.

[mamgo]

When we talk with manager today she said we must change job, barrow money from friends. Must stay and grow dept. Is it seriosly?

[Jingthing]

When we talk with manager today she said we must change job, barrow money from friends. Must stay and grow dept. Is it seriosly?

What is your nationality? You might need to make this a thing in the international press. Can your embassy help? It sounds like you feel you're being held prisoner. This type of thing happens sometimes at Thai hospitals ... but it would be embarrassing internationally.

Edited April 2, 2014 by Jingthing

[GrantSmith]

Not a typo by chance?

102 units of medical supplies?

84 units of medication?

Even for an adult that seems excessive...

Sent from my iPad using Thaivisa Connect Thailand mobile app

[mamgo]

It was natural delivery in correct time. Baby body was not broken. He breath amniotic liquid.Doctor said water was clean. Hospital refuse give us medical report. Do we have right take it?

We are from 2 countries. My embassy can not help. Another embassy will call tomorrow.

[mamgo]

Can they catch us to prison? Why just dont accept to change hospital if we are can't pay? we have one more child 5 years old, its so sad!

Edited April 2, 2014 by mamgo

[mamgo]

Thank you for advice. I will ask details list of all medication and sipplies. And we will try ask another hospital about it nessasary or not.

[Sheryl]

1. It is hard to believe that the medication charge is correct and the equipment charge also looks too high (though it may include a charge for the ventilator). Go to the Billing Dept and insist on an itemized bill listing what all these medications and equipment are.

2. While you are at the Billing Dept, ask to speak to the person in charge. Tell this person that you do not have the ability to pay for this care and want your baby transferred to a government hospital and that if this is not done, you will not accept any responsibility for the expense.

3. Go to the "Medical Coordination Office" (sorry, I do not know where it is located. But this is the name of it). Tell them you want to arrange transfer of your baby to a NICU in a government hospital, preferrably Chulalonghorn. Be very firm and insistant. I should warn that the transfer itself will be very expensive, as it will require a portable ventilator, NICU staff in attendance and so forth - this alone will cost as much or more as a day in the NICU. But in the long run it will save money.

4. If the Medical Coordination Office is not helpful, go yourself to Chulalonghorn Hospital and ask abut arranging a transfer. You will need a Thai speaker to go with you and it may take some time to find the correct office, but once you do they will be able to tell you if they have room in the NICU and whether they can arrange to pick up and transport the baby. Be sure they know the baby is on a ventilator.

5. Send a letter addressed to Mr. James Banner, Bumrungrad Hospital CEO that says something like this:

"Since (date) our newborn baby has been cared for in the Bumrungrad NICU despite our repeated statements that we do not want the baby treated here and wish to have the baby transferred to a government hospital NICU, and that we do not have the ability to pay for care at Bumrungrad.

Please by advised that effective immediately we, the parents of this baby, refuse treatment at Bumrungrad Hospital and will not be responsible for any further costs incurred for treatment, other than costs connected with the baby's safe transport to a government hospital".

Sign it by both parents and then list carbon copies to:

Mr. Keneth Love, Chief Financial Officer

Dr. Dr. Num Tanthuwanit, M.D., Chief Medical Officer

Bumrungrad Hospital Billing Department

Bumrungrad Hospital Medical Coordination Office

JCI - Office of Quality Monitoring (One Renaissance Blvd, Oakbrook Terrace, Il 60181 USA)

The Medical Council of Thailand (7^th Floor, Office of the Permanent Secretary, The Ministry of Public Health,
Tiwanond Rd., Nonthaburi 11000, Thailand. )

Your Embassy

Send it by DHL or Fedex so that someone has to sign for the receipt, and do this TODAY. From here on, all communications need to be in writing. And whatever you do, do not sign any forms the hospital gives you unless it is clearly a form related to transferring your baby out (for that, they will want you to sign a waiver of liability).

6. You could also call the Thai Medical Council, this will need a Thai speaker. tel:

(0)2590-1880-1, (0)2590-1884, (0)2590-1886-7, (0)2590-1888-9 The point to emphasize is that the hospital is treating your baby without your consent and has ignored your request to transfer the baby to another hospital.

7. Make an online complaint to JCI on this website http://www.jointcommission.org/report_a_complaint.aspx Again, same point to emphasize. Do not go into the cost details, just stress the hospital is treating your child without your consent and has refused to transfer the child to another hospital as requested by the parents.

If you do all this properly there will probably be a response. However:

1 - your English is not very good, so try to have a native English speaker help you with the letter and online complaints, and also if possible with the discussions.

2 - You need to understand that there are risks inherent in transferring a newborn baby on a ventilator, though with proper planning, equipment and staff it should be possible to do. But it can only be done if the receiving hospital is prepared with the necessary equipment all set up, and if specially trained NICU staff accompany the baby in transit. You can't just take the baby out and show up somewhere, it all has to be very carefully arranged and planned with close medical supervision every step of the way. There will be a significant cost for this.

[mamgo]

Sheryl

thank you very much for your help!

We start try tranfer our baby to Chulalonghorn (thank you for intruduce this hospital). But hospital requirement Burmrungr doctor call them and ask about transfer which she did not prefer.

We are ready to go ourself to Chulalonghorn but for that I think we need full medical record about illness and treatment of our baby which we asked and could not get already 2 days.

Does wehave right to ask and recieve lab tests and x-ray results of our child? If not can they give it for our embasy?

Thank you for help make official letter refuse treatment. We try it already but it was not acceptable also.

Unfortunatelly today we sigh some not clear contract about future payment when pay initial fee 100 000 bahts. Financer staff said we will make another installment plan when full bills will be ready.

Today doctor said our baby need treatment not less than one month. I also doubt about it and want to have possibility get consultation from another doctor.

Тhanks again.

[bina]

sheryl i remembered there were similar cases:

:buddhist druid was one:
http://www.thaivisa.com/forum/topic/365647-urgent-assistance-required/

and gunnyd who lost one of his triplets and also had a humoungous bill to pay and was asking for advice... not sure if he could be contacted but maybe he has suggestions?

never followed up but who knows , maybe they got lawyers or something but maybe they have an idea

[Sheryl]

1. You have an absolute legal right to all medical records concerning your child and legally the hospital cannot refuse to provide this. To obtain these records, go to this website: https://www.bumrungrad.com/en/medical-record-request, fill out the required information and then the request form. Be sure to submit it to the correct place which is probably the Medical recrds Office. Do not hand it to the doctor or nurses in the NICU, that is not the correct process.

2. I do not understand the sentence " Thank you for help make official letter refuse treatment. We try it already but it was not acceptable also.". Did you send the letter as advised or not, with all the various cc's? How did you send it? It should have been by DHL separately to all of the different recipients. If you just handed it to the doctor, that is incorrect and useless.

"Not acceptable" to whom? Who exactly are you speaking with at the hospital? Naturally they will not like the letter, but if you sent it you have placed them on notice that they do not have your consent to treat your child and are not responsible for any further charges. It will take some time for the letter (if sent to the various different recipients as suggested) to reach the appropriate people's attention.

3. You absolutely should not have signed the payment contract, and by doing so you lost important leverage. Do not sign anything further of that sort. If as advised you sent the letter stating you do not consent to the baby being treated at Bumrungrad and will not be responsible for the costs as of the date of that letter, you must stick to this. You have rights, but only if you insist on them. If you sign them away, no one can help you. From the date of reciept of the letter refusing treatment, they are on notice that treatment is against your wishes and that you are not financially responsible. Stick to that and do not back down. I assure you that once it is clear to the hospital that they will not be paid for any further services rendered , they will rapidly move on effecting a transfer to another hospital.

4. Have you been in touch with the Medical Coordination Office? This is whom you need to communicate regarding transfer, not the doctor. Of course they will have to get information from the doctor (who cannot refuse to provide it) but it is that office who will call Chula and make the arrangements. I do not know where they are located but the information desk on the ground floor should be able to tell you. Also they have this email:< [email protected]> If you email them, say something like:

"Our newborn baby (Hospital number....) is currently a patient in Bumrungrad's NICU. We do not consent to any further treatment at Bumrungrad and instruct that the baby be immediately transferred to Chulalonghorn Hospital. Please contact us at once at (telephone number) to discuss this. We will not be responsible for any costs incurred for continued treatment at Bumrungrad in violation of our stated request for transfer".

5. Have you gotten the itemization on the medication and medical supply costs on the initial bill? The medication in particular is doubtful, either there was an error or they charged uo front for a full course of treatment (sometimes this is done when for example they have to order or open a large quantity of the drug at once), in which case further days treatment should be less costly.

6. You have an absolute right to change doctors even if the baby stays at Bumrungrad.

7. It sounds like you are not being assertive enough in your dealings with the hospital, and possibly also talking to the wrong people. You should be telling, not requesting, and it is not up to them to "accept" your instructions (beyond of course their right and obligation to ensure that the child's life is not endangered in the process).

8. As it seems to be hard for you to insist on your legal rights I think you should consider hiring a lawyer and let the lawyer take over communications. A lawyer will of course cost money but may save it in the long run if it succeeds in getting your baby transferred. Your Embassy will have a list of suggested lawyers in Bangkok. Or you could try this place which is not too far from Bumrungrad http://www.thailand-lawyer.com/medical-malpractice.html or one of these http://www.hg.org/law-firms/medical-malpractice/thailand/bangkok.html

(your situation is not exactly malpractice, but lawyers with malpractice experience would be best). Properly handled it will not take too much of a lawyer's time to get this sorted out.

9. Regarding your legal rights please see http://thailaws.com/law/t_laws/tlaw0368.pdf section 8:

"Section 8

In providing health service, public health personnel shall provide health information in

connection with the service to the service receiver as adequately as to decide the proper

choice of service. In case he or she refuses to receive service, no person shall provide

service to him or her."

10. While it will greatly strengthen your position to identify a hospital willing and able to take the baby, I think you will find it hard to deal with Chulalonghorn Hospital bureacracy. Another option, which has a NICU, is St Louis Hospital. It is private but not for profit, will cost more than Chulalonghorn but much less than Bumrungrad and be a lot easier to deal with than Chula.

http://www.saintlouis.or.th/main_page.php

It is near the Surasak station of the BTS (change at Siam Square) and best to just go there and start with the nurse at the registration desk, explaining that you want to arrange transfer of a baby from the NICU at Bumrungrad to the NICU at St Louis. (If they ask you to sign anything, do so).

[Sheryl]

I mentioned your problem to a legal group which is a Thai Visa: www.siamfirm.co.th and received the reply:

"The hospital has no right to withhold a patient.We will be able to assist you on this. Please give us more info."

Please contact them. They are located near Bumrungrad:

496-502 Amarin Plaza Building 5th. Ploenchit Rd, Pathumwan, Bangkok, 10330

Tel 02 2569150

Mention that you are the case Sheryl from Thai Visa told them about.

[inthepink]

I'd insist on my rights at this point, make it clear I have no intention of paying for any further medical services, and leave any legal help until later. Getting solicitors involved at this stage is only going to cost even more money.

[mamgo]

Sheryl, THANK YOU VERY MUCH FOR yesterday letter. Today we transfered our baby to Thamasat hospital, it was available.

Now I am in bus going back to Bangkok. I will write details later.

[kriswillems]

Edit: advise deleted because problem mostly solved thanks to the great help of Sheryl!

Edited April 4, 2014 by kriswillems

[Sheryl]

Glad to hear it has been resolved.

I hope your baby does well.

[Jingthing]

It's amazing when people get helped this dramatically by using this forum.

[TheAceFace]

This is what forums are for, especially TV.....Great work Sheryl.

To the OP, are you or the family in anyway medically insured, maybe that would cover some of the cost?

As others have said....glad you got the transfer and good luck with your baby.

[Jingthing]

Thanks to Sheryl and thanks to the famous George and everyone behind this forum. Yes, it exists as a commercial business but it also helps an awful lot of people in a huge variety of ways ... FOR FREE.

OK, I've filled my quota for you know what kissing for the year now!

Edited April 4, 2014 by Jingthing

[Showbags]

Sheryl's on the job...awesome effort there.

It is such a shame many of these Inter hospitals seem to be going down the path of greed and missinformation than they were several years ago.

When I first went to Bumgrab, it was great....now it seems not so much.

Hope you can stick it to them OP in regards to the costs and overcharging.

Hope the little one does ok.