Hi, my adult child was admitted as an emergency to a Dublin hospital via our local hospital medical assessment unit, he is now waiting on a (serious) procedure to be carried out, he is in a small public ward, there are no private rooms available and he prefers the ward anyway, is there any benefits to him by signing as a private patient, which the hospital administration is looking for or will his treatment be exactly the same if he says he wants to be treated as a public patient, or will this affect any follow up medical appointments as a result of his treatment, I asked the insurance company but they just say it's up to him and are a bit vague with their answers, ?
Private or public patient
- Thread starter Shelby219
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Hi,
My understanding is that he should not sign the form until the hospital confirm that he will receive a private room which he does not appear to want so he should confirm that to the hospital administration. He could also discuss with them about getting private treatment from the consultant if he wants this or if that is an option.
This previous thread might explain the situation better especially the replies from Starrynights.
See here also for some newspaper articles explaining the situation.
Quite surprised about the health insurers reply as it could save them a lot of money.
My understanding is that he should not sign the form until the hospital confirm that he will receive a private room which he does not appear to want so he should confirm that to the hospital administration. He could also discuss with them about getting private treatment from the consultant if he wants this or if that is an option.
This previous thread might explain the situation better especially the replies from Starrynights.
See here also for some newspaper articles explaining the situation.
Quite surprised about the health insurers reply as it could save them a lot of money.
This is a pretty good explanation ... 20 mins long.
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Starrynights
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Hi,
As Sue mentioned above, if you go to the end of my last post on that link it might have some info helpful to you. The bill privately will be much bigger than the bill publicly. Either bill will be covered by direct payment from the insurer.
There are some risks/ info that is important to know before you sign the waiver. Is the medical issue pre existing/ how long have you had insurance for? After 5 years of continuous cover all conditions are covered. Prior to that the insurer will only cover new conditions (technically conditions that did not have sign/symptoms in the 6 months prior to taking out insurance). When you sign the waiver you become solely responsible for all bills not the insurer. Of course the insurer will pay for what's covered but legally the hospital is billing you so you are responsible if something turns out not to be covered. Also if you need outpatient follow up care this can be billed privately. In that case you'll have to pay the consultant fees directly for each visit as you would in a private hospital.
The insurance company is vague as they do not want to take any liability for potential future issues with your choice. In reality they probably want you to remain public as they will be billed only €80 per night vs €813 - €1000 per night + all doctor/diagnostic/treatment fees separately billed on top.
As Sue mentioned above, if you go to the end of my last post on that link it might have some info helpful to you. The bill privately will be much bigger than the bill publicly. Either bill will be covered by direct payment from the insurer.
There are some risks/ info that is important to know before you sign the waiver. Is the medical issue pre existing/ how long have you had insurance for? After 5 years of continuous cover all conditions are covered. Prior to that the insurer will only cover new conditions (technically conditions that did not have sign/symptoms in the 6 months prior to taking out insurance). When you sign the waiver you become solely responsible for all bills not the insurer. Of course the insurer will pay for what's covered but legally the hospital is billing you so you are responsible if something turns out not to be covered. Also if you need outpatient follow up care this can be billed privately. In that case you'll have to pay the consultant fees directly for each visit as you would in a private hospital.
The insurance company is vague as they do not want to take any liability for potential future issues with your choice. In reality they probably want you to remain public as they will be billed only €80 per night vs €813 - €1000 per night + all doctor/diagnostic/treatment fees separately billed on top.
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Just to give an update, firstly my son is doing well and has been discharged.. When I called in person to the admissions office to sort out the payments,/insurance ,I said I wanted him treated as a public patient and was told that was no problem, just sign the insurance direct payment form and also if you could also sign this other form which stated "I waiver my rights as a public patient" and the charge was €813 per night, I naturally said no , I will only sign the insurance direct payment form not the hospital waiver form, to which I was told,no that's not a waver form, (even though it clearly stated it,) and they couldn't accept the insurance form unless I signed the other one and I would be billed by the hospital and would have to claim the payments myself if I didn't sign both. I just brought the two forms home with me and posted one back to the hospital.
Sounds like absolute nonsense. You did right.
Final update, there was two bills to settle and the insurance company paid both directly to the hospital,at the public patient rate even though on the second bill , when I handed back the two forms ,,,,(the white hospital one unsigned) the lady in the office followed me down the corridor and challenged me why I had not signed it! Then stated the hospital would not get paid anything if I didn't sign both,! This is unbelievable carry-on by administration staff, are they on commission or what is going on?
I don’t think they are on commission but they are under pressure to get those who have private health insurance to sign that they will be treated as private patients, even though your son clearly had a medical emergency and would have been treated in any case.
You are probably lucky that they asked you to sign rather than your sick son. Often the ill person will get “admission” forms to sign, and they have no clear understanding that they are moving from public to private care. You really have to have your wits about you, and query the paperwork.
I saw this myself with my elderly Dad who was asked to sign papers in his hospital ward. Luckily we were there and queried what the forms were about. Then we pointed out that the admin guy had said something completely wrong when he first appeared in the ward and wondered why the hospital were deliberately setting out to mislead an elderly vulnerable sick patient. There was a lot of backtracking on the admins part, but it was a ploy to get the signature.
I am glad your son is doing well
You are probably lucky that they asked you to sign rather than your sick son. Often the ill person will get “admission” forms to sign, and they have no clear understanding that they are moving from public to private care. You really have to have your wits about you, and query the paperwork.
I saw this myself with my elderly Dad who was asked to sign papers in his hospital ward. Luckily we were there and queried what the forms were about. Then we pointed out that the admin guy had said something completely wrong when he first appeared in the ward and wondered why the hospital were deliberately setting out to mislead an elderly vulnerable sick patient. There was a lot of backtracking on the admins part, but it was a ploy to get the signature.
I am glad your son is doing well
They are not on commission as such but they might have KPIs.
My brother was admitted straight to ICU and put in a private room. Two letters trying to get him to sign the waiver. I told him each time not to.
I heard years ago the income from PHI pays the nursing wage or most of it in a public/voluntary type hospital.
If you want to follow up on this then you should check the hospital's customer/patient charter and complaints process. I've had to do that in the past in relation to non-insurance related billing issues with a Dublin hospital.
My family member was told, even though she was admitted to a public ward via A&E, that she should sign the form as it meant that she would have access to the main consultant whereas if she didn't sign, she would only see his team. She held out for her first time in, but the second time shortly after the first, again admitted through a&e, she relented as she was scared.