01 Oct 2007
REVISION OF PRIVATE HOSPITALS AND MEDICAL CLINICS GUIDELINES. PROVISION OF INFORMATION ON CHARGES, BILL ITEMISATION AND OPTION FOR FILLING OUT PRESCRIPTIONS IN MEDICAL/DENTAL CLINICS
- Under Regulation 11^1 of the Private Hospitals and Medical Clinics (PHMC) Regulations, all hospitals (restructured and private) are required to provide financial counseling to their patients so as to allow them and their family members to make an informed choice.
- Paragraph 7.9^2 of the PHMC Guidelines '1st Ed.; Jan 1993), which are
issued pursuant to regulation 4(1) of the PHMC Regulations, also requires all medical and dental clinics to make available to patients, prior to the consultation, information on charges which are likely to be incurred for consultation, investigation and treatment.
- To enable the public to make an informed choice, and to provide for
greater transparency, please take note that the Ministry will be revising paragraph 7.9 of the Guidelines to include the following:
Display of common charges
Providing information on additional charges
Bill itemization
Option for filling out prescriptions
- Accordingly, paragraph 7.9 of the Guidelines (including its heading) will be
replaced with the new guidelines (paragraphs 7.9 -7.13) set out in the Annex.
- These revisions shall come into immediate effect except for sections 7.9
and 7.11 which will come into effect on 1 April 2008.
Provision of Information on Charges
- Display of common charges:
Information on the common charges should be prominently displayed within the medical clinic or dental clinic, for example on boards, tent-cards, etc. Supplementary brochures or pamphlets with details of the clinic’s charges may also be provided. The charges may be displayed in the form of a fee range and shall include the following types of charges, where applicable:
- Consultation fees, e.g. long consultation, short consultation, weekend and public holidays consultations, after office hours consultations
- Vaccination/Immunisation
- Health screening and Medical reports
- Providing information on additional charges
Patients should be informed of when additional charges will be incurred, for investigation, treatment, procedures etc.
Bill Itemization
- Patients should be informed of every item charged for the clinic visit, e.g. consultation fee, medication (itemized) charges, investigation charge, etc. through itemized billing.
Option for filling out Prescriptions
- Patients may either fill out their prescriptions at the clinic or to purchase the medicines from any pharmacy of their choice. They must be given prescriptions to purchase the medicines from any pharmacy of their choice, if they request for it.
- Patients should be informed of this option, either verbally, or by means of notices clearly displayed in the clinic.
Frequently Asked Questions
General Queries
- Will there be a prescribed MOH format for the clinics with regard to how they should display the information on fees and charges?
Clinics are free to design their own format on how the information on fees and charges will be displayed.
- There are no longer SMA’s Guidelines on fees for clinics to follow. How do I know whether I am undercharging or overcharging?
The fees charged should be reasonable and acceptable to the professional community. The Singapore Medical Association has announced that it will be conducting a survey on clinic charges and professional fees, and that the data will be published.
Display of Common Charges
- How should I display and provide the information?
The clinic charges should be displayed prominently on boards, tent cards or notice printouts, and, if necessary, supplemented with printed pamphlets or brochures. The charging information should be prominently and strategically displayed for the convenience of the patients. Verbal advice should also be given if required.
- What are the common charges that I will have to display?
Charges for routine services being provided by the clinic should be displayed. Some examples are consultation, health screening, medical report, vaccination charges.
- Must I display the actual charges for consultation, vaccination /immunization, health screening and medical reports?
Yes, if the charges are standard/fixed. Display of charges in the form of a fee range is acceptable, e.g.
Long consultation $X - $Y
Short consultation $X - $Y
Vaccination/immunization $X - $Y
Health screening $X - $Y
Medical reports $X - $Y
Providing Information on Additional Charges
- What do you mean by additional charges?
These are for services that the patient may not expect to need initially, but deemed necessary during or after consultation, e.g. lab/xray investigation, injection, surgical procedures like toilet and suture.
- When and how should I provide information on the additional charges?
Such information should be provided before the additional services are rendered (except for emergency cases), either verbally during or at the end of the consultation when the treatment plan is decided.
Bill Itemization
- What do you mean by bill itemization?
Every patient has to be presented with a bill. The bill must list every service and the amount that the patient is being charged for.
Example of a bill for treatment of fever, cough and cold:
Consultation fee $a
Full blood count $b
Panadol $c
Clarytyn $d
Phensedyl $e
Total $T
-
Must the itemized billing be computerized?
Not necessary. It can be handwritten or a computer printout.
- Can I bundle the medication charges as one lump sum?
No. You are required to show each and every medication dispensed and the amount charged.
- If I intend to computerize my system for itemize billing, is there any particular company my clinic could approach?
There are, in the market, a number of clinic management softwares that provide prescription and itemized billing functions.
Option for filling out Prescriptions
- How do I inform patients that they can request for a prescription to buy the medicines from any pharmacy of their choice?
You can either inform your patients verbally during consultation or by displaying the information on notices, tent-cards, boards, etc.
- Is it my responsibility to source a pharmacy for my patients if they
request for a prescription to buy medicines from elsewhere?
It is good doctor-patient relationship if you can advise your patients who prefer to fill out the prescriptions where the nearest pharmacy is, or advise where they can obtain the list of registered pharmacies i.e. at the Health Sciences Authority’s website: http://www.hsa.gov.sg/prism/common/enquirepublic/SearchPharmacy.do?action=load
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