6 things that can increase your hospital bill

Healthcare is a service which is very unpredictable in its cost. Patients often has very little say in his/her own treatment and thus may not have adequate control over the cost. Information of cost is also not always given and very frequently patients find a bill at the end of treatment which is way beyond what they anticipated.

While it is expected from hospitals to inform the patient about the cost from time to time, patients must be aware about what can actually drive their cost on a higher side. By just being aware of these expense heads, can help a lot in keeping cost under control. (Also check this post on 'Pricing of Hospital Services' to know more)

      1.       Category of accommodation can impact cost of treatment

While charges for different category of accommodation in hospital may differ, it can also affect the charges of other treatment given to you. Many hospitals charge a premium price on same hospital services to the patients staying in higher category accommodation. Hence, a CT scan may cost Rs. 4000/- to a patient in general ward but Rs. 6,500/- to a patient in single room. The difference in charges could be as high as 200% between lowest and highest category of accommodation available in hospital. Worst still is that some hospitals may knowingly or unknowingly not inform about the premium pricing to a patient opting for admission in higher category.

While all hospital does not have this kind of pricing policy, it is always better to ask, if the choice of category is going to impact the cost of other healthcare services.

Passive Euthanasia in India and Making Advance Medical Directives: Details that hospitals and patients must know

Passive Euthanasia has been legal in India since 2011 after Supreme Court issued its judgement in Aruna Shanbaug’s case. Although the plea of the petitioner, Journalist Pinki Virani, was rejected, supreme court gave directives on when and how passive euthanasia can be allowed and executed in Shanbaug’s case, making passive euthanasia as legal in India.

A case on similar line, filed by an NGO ‘Common Cause’ was also going on whose plea was to make it legal for people to make Advance Directive for passive euthanasia. On March 9, 2018 Supreme Court of India upholds passive euthanasia and issued regulations for executing Advance Directive for passive Euthanasia.  The regulation passed through this judgement will remain binding across the country till the time, Parliament of India comes up with a bill or law on this subject.

The hospitals and medical fraternity (specially those that provide end-of-life care) need to make themselves aware about the legally correct way of handling advance medical directives for passive euthanasia. This post explains the legal directives in simple language for its correct implementation. The information presented here is derived directly from the 538-page official judgement report of the Supreme Court of India.
(Check - Advance Medical Directive Form for Passive Euthanasia)

      1.   What is Euthanasia and what is India’s legal stand on it?

How to choose right health insurance provider?

While we take great care in selecting best health insurance plan for ourselves, how to choose the health insurance provider is an equally important question to consider. If you observe carefully, you will find that most health insurance plans from different companies have similar terms and conditions. Their premiums, coverage limit and diseases inclusion/exclusion will also appear to be similar.

However, there are quite a few things about healthcare insurance providers (insurance companies) that could differ and provide you a sound basis of selecting or rejecting them. They are described below.

Also check - How to select a good hospital and How to select a good doctor

Checklist for pregnancy hospital bag when getting admitted to hospital.

A pregnant mother has to stay in hospital for about 5 days in case of Caesarean delivery and about 3 days in case of normal delivery. The days of stay may vary in some cases by 1 or 2 days depending upon the condition of mother and baby.  For Caesarean delivery the mother may be required to get admitted either 1 day before the day or about 12 hours before the scheduled time of surgery. In normal delivery, admission will be required as soon as the labour pain starts.

The family must be prepared with all necessary items that may be required during the mother’s stay in the hospital. This will prevent a lot of inconvenience to mother, baby and family members and they can spend more quality time with the new member of their family. First time parents should specially take out time to think through what all they should be ready with. Also, as in normal pregnancy the admission may be required on an immediate basis, it would be a good idea keep the bags ready with all required stuff, so that you are always ready for admission.

Here is a checklist of pregnancy hospital bag that you must consider while getting admitted in hospital.

For mother

1.       2-3 pairs of feeding gowns, cotton texture and lose fit and 1 set of clothes to wear

2.       Comfortable fitting undergarments (nursing bra), and socks

3.       Winter-wears, if required

4.       A pair of slippers, non-slippery

5 things you must check while getting discharged from hospital

Nobody likes to stay in hospital and patients eagerly wait for their day of discharge. After spending days or weeks in hospital the doctor’s order to discharge brings cheers to patient and their family members. The phase of troublesome treatment in hospital is over and patient wishes to go home as soon as possible. But wait, here are few things which must be taken care of before leaving the hospital to save you any troubles later on.

1.       Get your discharge summary – 

Although it is a routine for any hospital to hand over the discharge summary of patient before they leave, it gets missed many time. The discharge summary contains all important details related to patient’s disease, tests results, condition at the time of discharge, treatments given, further treatments to be taken and follow up advice. This is a very important piece of medical document that will be required for future medical treatments. In hospitals the process of discharge is pretty complex and preparation of discharge summary can take time and delay the entire discharge process. Hence, sometimes to avoid delay staff may let the patient go without discharge summary. Hence, as a patient you must ask for discharge summary and ensure it is with you before you leave hospital.

2. Collect documents related to health insurance claims – 

If you have health insurance and have not availed the cashless facility, make sure you collect necessary documents related to treatment for settling your claim with your insurer. You must enquire from insurance agency about specific documents required which generally includes, detailed itemized bills of treatment, individual investigation results, statement of doctor/hospital and of-course discharge summary. Some insurance agency also asks for a copy of complete medical record of the patient during the treatment. As a patient you have a right to get all these documents from the hospital.

3. Final talk with the treating doctor – 

The treating doctor or the consultant are busy people and they generally leave the discharge formalities to be completed by assistant doctors. However, he/she is the person who knows best about the condition of the patient and further course of treatment required. So, make sure to have a final discussion with the treating doctor to get an assurance about patient’s health and treatment.

4. Collect necessary information – 

As a patient you must ensure to get following information from the doctor/nurse at the time of discharge

a.       Medications to be taken at home

b.       Preventions to be taken (like food, activities etc.)

c.       Date of follow up, if required

d.       If the situation of patient worsen, how to get emergency help

e.       Signs and symptoms which can indicate patients to consult back

f.        Any other special or specific instruction related to patient’s disease

5.       Check the settlements – 

At the time of discharge all payments need to be settled. While settling the bills, take care of following

a.  Check if the bill is right and error free. 

b.  Check if you have received the refund for unused medicines returned to hospital
c. Check if the bill has reduced the advance amount or any security deposit paid by you

Other posts of interest

5 points on how to select a good hospital

What is accreditation in hospital and how does it matter to me as a patient?

4 points on how to select a good doctor

5 points on how to select a good hospital

When it comes to our healthcare we should not take chances with the hospital from where we are planning to get our treatment done. While recommendation (reference) from our primary doctor is important, following points must also be checked to ensure that the hospital we select is a good one and match our need.

4 points on how to select a good doctor

Doctor is the most important person on whom the fate of patient’s treatment depends upon. Hence for any major treatment it is absolutely important to select a doctor who is the best for you. But due to complexity and technicality of medical field, most common people find it difficult to decide about selection of doctor. Here are 5 points that one can use to select a good doctor for themselves. (Also check my post on ‘5 points on how to select a good hospital’)

What is accreditation in hospital and how does it matter to me as a patient?

Hospitals are one of the most complex organizations ever built by human beings (Peter Drucker). A large number of functions happens in a hospital and each function is important for effectively delivering healthcare to patients. For common people it is virtually impossible to get information of these internal functions of the hospital or to understand how it affects their healthcare. This limitation on part of patient group, many time results in selection of hospitals that lack basic quality features necessary for providing medical care to patients. Thankfully, there is a solution to this problem in form of ‘accreditation’, which is a mark of quality in hospitals.

6 points that should be taken care of while assessing online customer reviews of hospitals

Selection of good hospital is crucial to get a good medical treatment. My article on ‘5 points on how to select a good hospital’, describes important points that must be checked to select a good hospital. One of the key point in it is to check the online reviews of the hospital shared by other patients. While online reviews can give invaluable information about the hospital, it can sometimes be tricky in discerning right information. One need to be careful while basing their decision on online reviews. Here I have stated few important points that should be kept in mind while going through online reviews of hospitals.