MOH urges openness and transparency in billing

12 Jun 2008, The Straits Times

Question

Name of the Person: Pual Chan

Why are doctors dragging their feet over itemising their bills?

June 6, 2008

I am amazed to read the report that some GPs were still not issuing itemised bills two months after the deadline for the guideline came into effect (Some GPs yet to itemise bills, June 2). One even refused a patient an itemised bill.

Nearly 50 per cent of GPs surveyed ignored the deadline, but this may just be the tip of the iceberg.  The Singapore Medical Association can help to enlighten the public as to whether the number of reluctant GPs is indeed so high.

The health authority's directive to itemise consultancy fees and the cost of medicines supplied is a step in the right direction towards making Singapore the medical hub for this region. It is plain logic that showing the charges for consultation and medicines separately will provide clarity for patients on the billing process. Patients can then choose to ask politely for a prescription to purchase the drugs elsewhere if the drugs are priced too highly at the clinic. Are doctors above directives from the health authority?

It is difficult to fathom why some doctors are dragging their feet despite the advance notice given to initiate changes to streamline the practice of billing.  One doctor who failed to comply with the directive explained that he was trying to keep the cost down for needy patients by not itemising his bill. By not doing so, he could apparently subsidise his consultation fee and margins of medications. But would it not be more magnanimous to needy patients to show them the prevailing consultancy fees and charge the medicines separately at cost or below cost with the information printed clearly on the bill?

It is necessary to establish fair trade practices in the health-care industry in order to attract international patients.

Defiance or delaying compliance will not help the medical fraternity to project a good image.

I agree with the views of Madam Halimah Yacob, head of the Government Parliamentary Committee for Health, that there is no reason why medical doctors should not itemise their bills if they consider their practice as a business for profit.

Reply

Reply from MOH 

MOH urges openness and transparency in billing

Mr Paul Chan asked “Why are doctors dragging their feet over itemizing their bills? in ST, 6 June 08.

The Ministry of Health (MOH) expects our doctors to be open and transparent with their patients on their medical bills, since we issued the guideline on bill itemisation last October.  All doctors have been directly informed by MOH so they should know about it. The itemised bill can be handwritten or a computer printout.

Giving patients itemised bills is particularly useful where the bills are large.  Examples of such bills would be those billed by specialists, where the patient requires multiple medications.  Such patients may want to know how much they are being charged for their various medicines.  Itemisation of such bills will help the patients decide if it would be more cost effective to fill the prescriptions elsewhere. 

Patients who are unable to obtain itemised bills from their doctors despite their requests may feed this back to our Ministry at 1800-225 4122 orMOH_info@moh.gov.sg.