Oversight by hospital on MediShield claim submission

24 Feb 2007, The Straits Times

Question

Name of the Person: Low Joo Ming (Mr)

Oversight by hospital on MediShield claim submission

MediShield claim for angioplasty rejected

SINCE July 1, 2005, the Ministry of Health has reformed the MediShield scheme to provide more claims for MediShield reimbursement for "room and board" ICU and surgical fee. The premium was raised accordingly. Recently, I had an angiogram and angioplasty. The hospital submitted my claim for Medisave as well as MediShield reimbursement. The Central Provident Fund (CPF) Board rejected my claim for MediShield and I was allowed to use $2,200 from Medisave towards my total bill of $17,000. 

I would like to know why the MediShield claim was rejected. Surely this is not the objective of the MediShield scheme which aims to lower the burden of patients. In 1997, I had a similar angiogram and angioplasty. Then, I was allowed to use $4,000 from Medisave and $1,600 in MediShield reimbursement. 

Reply

Name of the Person: Jennifer Chng (Ms)

Corporate Development Manager

Mount Alvernia Hospital

Name of the Person: Bey Mui Leng (Ms)

Assistant Director (Media Relations)

Ministry of Health

Oversight by hospital on MediShield claim submission In "MediShield Claim for Angioplasty rejected", Mr. Low asked why his MediShield claim for a recent angiogram and angioplasty was rejected. He had a similar procedure in 1997 and he had MediShield reimbursements then. 

CPFB and Mount Alvernia Hospital have since clarified with Mr Low on the case. There was an oversight in the MediShield claim submitted to CPFB. As a result, Mr Low's total hospital bill was assessed to be below the MediShield deductibles and hence he did not receive any payouts. Mount Alvernia Hospital regrets the oversight and has since resubmitted the claim to CFPB. Mr Low will now be receiving his Medishield reimbursements. The hospital has also taken the necessary steps to prevent future occurrences.