On December 2, 2022, Ms Saree Ongsomwang, Secretary General of the Council of Consumer Organizations and Sub-Committee on Protection of Rights and Promotion of Participation by NHSO, together with Assistant Professor Yupadee Sirisinsuk, Deputy Secretary General of NHSO press conference to resolve the problem of people being picked up by the service unit for additional treatment
Ms. Saree for the NHSO to go down to inspect and find that there were 3,329 complaints about being billed in the last 5 years, worth 35.7 million baht. received a bill of 12,595.5 baht for treatment even though it was paid correctly or in case of being charged with disability In case of emergency In case of using drugs outside the main drug list, etc.
However, having a health insurance system to prevent the bankruptcy of the people The charge should not have happened, however, if it has been charged then a complaint can be filed. We are helping to follow up on this, given that in the end the hospital had to pay the money back, and they got 100% of all the money back. because it is considered that it is the right of the people to receive services free of charge But how to make this happen to the minimum or not happen at all?
So want 1. Consumers and people using the gold card service If it is used in a service unit registered with the NHSO, confirm that there should be no charges whatsoever. Heart surgery, knee surgery, emergency treatment, childbirth, physical therapy, off-label drug use These are service units in the parallel system. unable to collect money and 2. As for the hospital, if a complaint is made, it must be paid back with interest of 15 percent, which is the highest rate according to the law. leading to unnecessary wastage of money and being a burden on the hospital
“Whether public or private hospitals registered with the gold card system cannot collect money. Is it an emergency or not? It will be green and red, it can’t save money at all It can’t be collected in case any disease is treated, and people must also set their own mind. If you want to collect money, you must inquire before paying. In order not to have to complain on the hospital’s side, to reduce damage to interest payments, it should provide services in accordance with consumer rights,” said Ms Saree.
Professor Yuppadee said that complaints filed in the year 2018-2022 totaled 3,329 cases, which is about 500-1,000 cases each year, most found in Health District 13, Bangkok, totaling of 1,956 cases because people with Bangkok are not close to the service unit. Opportunity to raise a lot Overall, 33% were born in primary/regular care units/referrals, 67% were not primary/regular referrals/referrals.
The type of items collected The majority of them were medical expenses, drug expenses in the account, wound dressing expenses of 2,269 cases, a total of 30.08 million baht, followed by health promotion and disease prevention, 553 cases, 2.89 million baht, who went for health promotion services to prevent disease, such as vaccination, walking Get a service anywhere Because we pay the service unit on a case-by-case basis, when providing services, we can withdraw the NHSO on a case-by-case basis.
Assistant Professor Yupadee further said that in case of emergency patients, if they are red, unable to breathe, unconscious, etc., everyone has the right to receive treatment anywhere, whether in a public or private hospital. due to various Withdrawal expenses from your own agency, namely the NHSO, the Social Security Office or the Comptroller General’s Department. When it comes to yellow, patients often don’t know how it differs from red. But I know it’s an emergency can go to the NHSO registered service unit everywhere.
The service unit cannot collect money for all 3 colors of patients, but if the hospital is not in the parallel system Then it is true that it is not red. a charge may be made for people with disabilities We make special exceptions because this group has limited access to the service. The gold card therefore allows people with disabilities to use the service everywhere. Regardless of any service unit some service providers think they cannot receive the service confirm that it is not true People with disabilities can use the service everywhere.
or in case of being bitten by a dog, a rabies vaccination is required and charged for In fact, vaccines are drugs on the main drug list. Not an off-label drug The service unit arises in chartered form. At one point we distributed vaccines. but later we put money into the system There may be a financial officer or part of your health insurance. The hospital got it wrong. Most hospitals accept this information and will not charge. Maybe a small part of the collection.
The NHSO has published a handbook on Extra Bills that cannot be collected What cannot be collected? Services to promote disease prevention for people throughout the country, social security, civil servants, free maternity leave. There is no right to charge for patient expenses.
However, once understood, it is believed that the problem should be reduced. The answer should not be about collecting money from patients. If there is any service that the hospital thinks the NHSO is unfairly underpaying, the service provider is still unable to earn enough or the cost burden is too high. make a complaint so that the NHSO can follow up and examine the expenses and improve from time to time.
However, Assistant Professor Yuphadee said that When complaining through 1330, the system will bring the matter to the rights protection working group. If they can breach their rights, they are sent to the rights protection system under the quality protection committee which looks at service standards. And there will be an investigation and if the hospital still confirms that the right cannot be exercised, that it cannot be reimbursed, they will have to look at the people who use the service, what rights do they have? If it is a gold card and that service unit is registered with it NHSO will not collect money. In any case, if you want to collect money, call 1330 to inquire or the complaints receiving unit.
There will be steps to help discuss. make a letter to the agency Those hospitals give money back to consumers. And the law establishing the Council of Consumer Organizations gives the right to file a lawsuit on behalf of consumers. Anyone who encounters problems, please don’t keep them, can complain. In terms of social security, the principle is similar to the gold card. you can call helpline 1506.
