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

[harrry]

i hope your baby and her mother do well.

Good to hear you finally sorted it out.

Sheryl is someone very special on this forum. I have never known anyone to give the help and concern she gives so freely.

[Showbags]

i hope your baby and her mother do well.

Good to hear you finally sorted it out.

Sheryl is someone very special on this forum. I have never known anyone to give the help and concern she gives so freely.

If only they were all like her ...

Edited April 4, 2014 by Showbags

[fatdrunkandstupid]

Good job Sheryl.

Mods. This thread should be pinned, as the great posts by Sheryl can be referred to by anyone who is aware that a hospital is not acting in their best interests.

[davidst01]

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.

I have to agree with the opinion that some of these international hospitals are greedy.

I recently went to bumrungrad for a prostate infection and the cost of the antibiotics was substantial. I priced it at Boots and it was basically a 1/3 cheaper. on the same day my gf had an appointment with the obstetrician and got a pap smear etc. Her dr fee was 500 baht. my dr fee was 1900... just bc Im a white farang. Bumrungrad is a rip off

please OP tell us how much was the bill and if you were forced to pay or not

[chiang mai]

Nicely done Sheryl!

[gerryBScot]

Yeah great job Sheryl and to the original poster good luck to you and your baby - please let us khow how the baby is getting on. Many thanks

[Sheryl]

To be fair to Bumrungrad, the misinformation and lack of responsiveness to the parent's situation was occurring at a low level within the hospital and probably limited to a few individuals, and communication issues may have played a role as none of the parties involved were native English speakers. As soon as higher-ups were made aware of the situation, clearly and in writing, it was immediately resolved.

The moral of the story is to be firm, stick to your guns/assert your rights, put things in writing and to those in authority. Do not allow yourself to be fobbed off by lower level administrative staff nor by doctor(s).

As those of us living in Thailand know, "mai dai" ("cannot") often just means " "I don't want to bother" or "I don't know how to do what you ask" or "I don't understand exactly what you want and do not want to spend the time to try to figure it out" or "I'm not able/authorized to do this and I am too kreng jai to refer it to a higher up who could",

Along with "mai mee" it is a stock refrain and should not be too readily accepted at face value when it comes to health care issues. Rather it is often an indication that you need to move up the chain of command with your request.

OP: you still need to get the bill for that initial period resolved. Do not stop until you have gotten a full itemization of the medical supplies and medications and compared them to the patient record. Especially the medication.

Billing errors are a common occurrence.

[tkramer]

Sheryl,

Your ongoing contribution(s) to this forum is priceless!

[Showbags]

To be fair to Bumrungrad, the misinformation and lack of responsiveness to the parent's situation was occurring at a low level within the hospital and probably limited to a few individuals, and communication issues may have played a role as none of the parties involved were native English speakers. As soon as higher-ups were made aware of the situation, clearly and in writing, it was immediately resolved.

The moral of the story is to be firm, stick to your guns/assert your rights, put things in writing and to those in authority. Do not allow yourself to be fobbed off by lower level administrative staff nor by doctor(s).

As those of us living in Thailand know, "mai dai" ("cannot") often just means " "I don't want to bother" or "I don't know how to do what you ask" or "I don't understand exactly what you want and do not want to spend the time to try to figure it out" or "I'm not able/authorized to do this and I am too kreng jai to refer it to a higher up who could",

Along with "mai mee" it is a stock refrain and should not be too readily accepted at face value when it comes to health care issues. Rather it is often an indication that you need to move up the chain of command with your request.

OP: you still need to get the bill for that initial period resolved. Do not stop until you have gotten a full itemization of the medical supplies and medications and compared them to the patient record. Especially the medication.

Billing errors are a common occurrence.

Yes but who is authorising the exorbitant fees from the beginning ?

Certainly not the lowly staff.

Several years ago we had a price for a baby delivery package, think from memory it was 35k.

This was when we had to pay ourself.

Due to an awesome health ins broker we have, he got us in under insurance coverage for everything and when I signed off on the final bill....nothing different to what we were quoted in the initial package...the bill to the insurance company was circa 110k.

Same hospital.

[ozsamurai]

It certainly puts my mind at ease

A ) Having heard this was resolved, and the baby and family are where they need to be

B ) knowing that a person like Sheryl is around, kudos to you.

Oz

Edited April 5, 2014 by ozsamurai

[cheeryble]

I agree with Sheryl and generally Bumrungrad, whilst not pretending to be cheap, is exemplary including in their "realprice" estimates.

In fact the semi-thyroidectomy lump removal from my neck I had was estimated at 300k and came in at 200......for everything including detailed pre-diagnosis and pathology......no extras.

(May have been lower because I became pals with the senior doc).

The difference was I still have a functioning half a thyroid (enough) and don't need meds for the rest of my life which would have happened with the total thyroidectomy suggested by the Ram where the operation would have been 70-80,000 but then come the room, the meds, and all the other "extras"

The downside with Bumrungrad?

I don't like seeing doors in hospitals with "NO MEN ALLOWED" on them, making it more than obvious that the women are property in some sorts of the world.

Sent from my iPad using ThaiVisa app

Edited April 6, 2014 by cheeryble

[mamgo]

Thank you everyone for try to help us.

On Friday we transfered our rbaby to Thamasat University hospital.

His condition is still not good and critycal.

How did we transfered. I dont tknow whats help. I printed that letter what Sheryl teach us. But we was not sure what will happen if any gov hospital will not available but we sigh refuse medical service from Burmrungrad. So we did not send but show in costumer service. That day we could got medical record of our child and in evening transfered him to Thamasat.

On Friday we also went to Chulalonghorn Hospital, thank you for advice. Its looks nice atmosphere and nice people work there but NICU bed was not available.

Sheryl was correct. The total price was not 10 000 usd per day. The first day price was 236 000 Bahts. For second day total price 280 000. And last day total bill for teatment was 340 000 Bahts.

Then our child stay in Thamasat now and today doctor show us total bills for 3 days. Its 320 000 Bahts.

As I can remember first day cost 9600 Bahts, second day they up price to 40000 per day. And today we got really unusual price.

We have to pay one year 20 000 bahts every month for Burmrungrad and its absolutelly impossible to pay Thamasat.

So even goverment medical service wich is cheapest is too expensive for us. It is very sad and hopeless.

[mamgo]

About delivery in Burmrungrad it cost 61000 bahts wich is even less than they show in pakcage. Doctor was great I have nothing to say bad about delivery. Just we have unlucky case.

I want also say thank you for this forum and your help.

[cheeryble]

Mamgo very happy to hear Sheryl's advice worked out so quickly, but still sorry to hear of your tale.

Are you saying Bumrungrad settled for 240,000 (12x20,000) and are forgetting the rest.....or they want you to keep paying past one year?

I feel very fortunate to come from a country with a single payer, where we never had to worry about being "covered" for disasters like this.

We even got our teeth fixed free or nearly free when I was young.....well we simply paid into the big national health scheme which worked out very efficient according to the figures, and despite Fox News, still does compared to the alternative.

I didn't notice people dying in the streets or doctors crying about their lot (though some investors didn't get the same stockmarket opportunities in healthcare).

I wonder how much of Mamgo's bill will find it's way into the pockets of western pharmaceutical companies who use the full gamut of tricks including rigged markets, publication bias, selection bias, and "ever greening" of drugs.....anything to make their products look good and keep the price up. It bewilders me to think how a small number of people looking after a patient (along with others) and a handful of drugs or bits can come to the unholy amounts we hear.

Even now I feel I can't pay health insurance here in Thailand (not only the price but largely because it is so inefficient and open to abuse), and I need to guard my capital and pick and choose treatment and meds carefully as I am the health backstop for my extended Thai family and I got to hope I am choosing the best way for all of us.

Anyway Mamgo I didn't want to hijack your thread but I take every opportunity to bang my nationalised healthcare drum to stop people like you getting in situations like yours.

All the best of luck and happiness to your child and you.

Please keep us informed and we hope for good progress.

Sent from my iPad using ThaiVisa app

Edited April 8, 2014 by cheeryble

[Issangeorge]

Cheeryble, I come from Canada and we never had to worry about health insurance. Canada has single payer universal health insurance, unfortunately, because we live so close to the US and Fox News, it is constantly under threat by conservatives, but so far saner heads have prevailed. Thailand is lucky it also has a government health insurance, something Thailand can thank Thaksin for.

Sent from my i-mobile IQ X using Thaivisa Connect Thailand mobile app

[Sheryl]

Thank you everyone for try to help us.

On Friday we transfered our rbaby to Thamasat University hospital.

His condition is still not good and critycal.

How did we transfered. I dont tknow whats help. I printed that letter what Sheryl teach us. But we was not sure what will happen if any gov hospital will not available but we sigh refuse medical service from Burmrungrad. So we did not send but show in costumer service. That day we could got medical record of our child and in evening transfered him to Thamasat.

On Friday we also went to Chulalonghorn Hospital, thank you for advice. Its looks nice atmosphere and nice people work there but NICU bed was not available.

Sheryl was correct. The total price was not 10 000 usd per day. The first day price was 236 000 Bahts. For second day total price 280 000. And last day total bill for teatment was 340 000 Bahts.

Then our child stay in Thamasat now and today doctor show us total bills for 3 days. Its 320 000 Bahts.

As I can remember first day cost 9600 Bahts, second day they up price to 40000 per day. And today we got really unusual price.

We have to pay one year 20 000 bahts every month for Burmrungrad and its absolutelly impossible to pay Thamasat.

So even goverment medical service wich is cheapest is too expensive for us. It is very sad and hopeless.

Did you get the medication charge clarified? (1st day - Bumrungrad).

Wishing all the best for your baby but I agree, from the beginning it did not sound good.

It may unfortunately become necessary at some point to discuss with the doctors whether or not to continue extraordinary measures especially if significant brain damage is likely to have occurred, which I regret could be the case. You should ask about this.

[lopburi3]

Mamgo very happy to hear Sheryl's advice worked out so quickly, but still sorry to hear of your tale.

Are you saying Bumrungrad settled for 240,000 (12x20,000) and are forgetting the rest.....or they want you to keep paying past one year?

((cut))

Believe he earlier paid 100,000 in cash if I recall correctly.

[Sheryl]

OP, following up on what I just said -- the doctor in showing you the large bill may have been indirectly trying to get at this issue.

Thai doctors tend to be very indirect in their communications and to not want to openly give bad news. Be frank with the doctor that you are unable to pay this much and ask directly what the baby's chances are of (1) surviving at all and (2) surviving without significant disability/brain damage?

Also, get itemization on the 3rd day's bill as it is hard to understand why so large. Find out what it is that pushed up the cost so far.

I am sorry to bring up such a painful matter but you need to consider it and to get enough information to make an informed choice as to whether or not it is worth continuing to put the baby and yourselves through all this for much longer.

[kriswillems]

I feel sorry for you.

If your baby has a good chance on surviving without serious brain damage, I would go for it and don't care about the bills.

If not you might have to make a hard decision.

There are millions of Thais with debts they can never pay. They put all their property of other peoples name. They don't have bank accounts and they work for black money.

Being in a bad financial situation might cause visa problems in the future.

You might want to think about leaving the country (before you're put on some kind of blacklist) after this is all over.

Always keep enough cash money (not on a bank account) aside for airline tickets for 3 people.

I would leave via a land border and fly back home via a neighboring country (don't buy the airline tickets until you passed the border).

Also, if your wife would be Thai, you might want to make sure she has a passport and visa for your country.

[kriswillems]

One question. Is the mother Thai?

If your wife is Thai, the baby will have Thai nationality and should be able to use the government health insurance.

[cheeryble]

One question. Is the mother Thai?

If your wife is Thai, the baby will have Thai nationality and should be able to use the government health insurance.

Good point.

My wife's best friend had the government pay for private and protracted hospital treatment for lymphoma in CM and I'm talking 1 point something million baht. They will apparently sometimes do this if there we problems with placing in a government hospital.

Sent from my iPad using ThaiVisa app

Edited April 8, 2014 by cheeryble

[Sheryl]

Neither parent is Thai to my understanding.

[mamgo]

Did you get the medication charge clarified? (1st day - Bumrungrad).

Wishing all the best for your baby but I agree, from the beginning it did not sound good.

It may unfortunately become necessary at some point to discuss with the doctors whether or not to continue extraordinary measures especially if significant brain damage is likely to have occurred, which I regret could be the case. You should ask about this.

Yes, we got the medication charge clarified. It is 3 pages A4.

Thank you very much for your wishes and advises.

I understand about the risk. Probably we will continue treatment if there is any chance he will recovery. We can not pay full cost now and later, it is same stop medication or continue.

But it is very sad because difficult to understand about child brain condition untill 2-3 years. Doctors said they try to keep oxigen enought. But he got too much medication, too much e-rays (3 x-ray per day!), and also oxigen was problem.

Believe he earlier paid 100,000 in cash if I recall correctly.

Yes, we paid 100 000 in Barmrungrad for our child treatment (when discharge) and 60 000 for delivery. It is already large amount for us and difficult to pay anything for Thamasat.

cheeryble, thank you. Even we have insurance but it doesnt cover newborn child. I dont know what kind insurance need make for that.

We are both not thai nationality and we can not get thai national insurance even pay tax every month correctly.

kriswillems, I think about it too. Its little hard lost everything and start life from zero in another country. Especially when have small baby. But if there is no another way we have to do.

I did check laws of my country about money dept. There is no option to go jail.

Does anyone know how is about Thailand? If we just ignore next bills what can be happen worst? We dont have car, motorbike, house and salary is not high.

Anyway in these days we prepare all documents for our child. Citizen, passport, birth certificate.

[cheeryble]

cheeryble, thank you. Even we have insurance but it doesnt cover newborn child. I dont know what kind insurance need make for that.

The beauties of owning an insurance company.

Again best wishes.

[Sheryl]

Mamgo,

If you are employed and paying Thai taxes you should be enrolled in Thai Social Security which I believe now covers delivery costs (see http://www.nationmultimedia.com/national/SSO-to-cut-red-tape-after-newborn-baby-dies-30217085.html). There has been talk about expanding to to cover complications in newborns but I am not sure where that stands.

You should be registered at a Thai hospital, SS covers only care at a hospital you are registered at or one that it refers you to, except in the case of delivery where they will reimburse a flat amount regardless of where you delivered. So you might be able to get a small amount of what you paid to Bumrungrad reimbursed.

If you are not registered anywhere talk to your employer, by law they should have been deducting SS enrollment fee from your salary monthly and you should have been issued a SS card. If you are eligible to be under the SS scheme but not registered anywhere it is possible you could register at Thammasat and that the hospital could get paid by SS, so look into this.

Even if not, you should sort this out for future health cover.

For information you can contact the Thai SS Office http://www.sso.go.th/ has a list of office locations and contact numbers.

[kriswillems]

You'll not go to jail in Thailand because you don't pay your bills but you might be put on a immigration blacklist that prevents you from leaving the country.

All property you have (in Thailand) can be taken from you (So, make sure you keep some property or money abroad).

All money on Thai bank accounts can be taken from you.

You'll be called to court and you'll need to prove you don't have any income or property abroad.

If the court could prove that you've money or property abroad, but you don't want to pay, you can end up in jail anyway.

You can forget about retirement visas because you would need 800000B on a bank account.

If you don't have money to support visa extensions and you can't leave because you're on the blacklist, you'll end up staying illegally in the country and could end up in jail too.

In the end it will be difficult to have a good life in Thailand and you might think about leaving before you're put on the immigration blacklist.

Edited April 11, 2014 by kriswillems

[Sheryl]

I very much doubt that a government hospital (which is what he will be in debt to) would pursue such measures.

And, they would probably agree to a very long term payment plan.

[kriswillems]

I very much doubt that a government hospital (which is what he will be in debt to) would pursue such measures.

And, they would probably agree to a very long term payment plan.

You're probably right. In the end it's much better to be in debt with a government hospital that with some small private company, because the hospitals play by the rules and don't want bad publicity.

Still the issue of having enough funds to support getting a visa is important. If the thread starter has a visa because of his work, he'll not need to fear as long as he can keep the job. But if this is not the case keeping a visa should have higher priority than all other expenses.

Also being is this situation, absolutely avoid borrowing money from small companies or loan sharks.

Edited April 11, 2014 by kriswillems

[NancyL]

A very sad situation. It's been my experience that government hospitals are very willing to work out extremely long-term payment plans.

But, be very careful to keep detailed records of payment, especially if you're not making the monthly payments in person, but instead using bank transfers. They'll simply give you a bank account number and often the hospital doesn't have a good way to match up receipts with specific contracts. At some point, you may have to go into the hospital in person to demonstrate you've been faithfully making the monthly payments via bank transfers.

Unlike private hospitals, government hospitals won't ask to hold anything (like passports) as collateral, either, when they establish a payment contract. However, they can report someone to Immigration if they fail to keep to the terms of a payment contract.

Overall, it's not a bad situation to have a large debt to a government hospital. I've known people who have taken as long as 6 or 7 years to pay off a large bill to a government hospital.

[Sheryl]

A very sad situation. It's been my experience that government hospitals are very willing to work out extremely long-term payment plans.

But, be very careful to keep detailed records of payment, especially if you're not making the monthly payments in person, but instead using bank transfers. They'll simply give you a bank account number and often the hospital doesn't have a good way to match up receipts with specific contracts. At some point, you may have to go into the hospital in person to demonstrate you've been faithfully making the monthly payments via bank transfers.

Unlike private hospitals, government hospitals won't ask to hold anything (like passports) as collateral, either, when they establish a payment contract. However, they can report someone to Immigration if they fail to keep to the terms of a payment contract.

Overall, it's not a bad situation to have a large debt to a government hospital. I've known people who have taken as long as 6 or 7 years to pay off a large bill to a government hospital.

My experience as well. As long as you are making a good faith effort, even if it is one that requires years to complete, I think you will be OK.

But do look into the Soc Sec angle, if nothing else you may be able to get 18,000 baht or so of the delivery fee reimbursed to you.

I forgot to mention but if by chance either of you are from neighboring countries you might qualify for a new government scheme to insure migrant workers. Let me know if this is the case and I will advise further.