The Ministry of Health (MOH) is seriously considering to introduce compulsory itemised billing to make fees more transparent due to the raising numbers of patients’ complaints related to how much they are being charged at Community Health Assist Scheme (Chas).
In Parliament on July 11, in response to questions asked by Er Lee Bee Wah, Member of Parliament from Nee Soon GRC on how many complaints have been received from CHAS cardholders against the clinics listed under the programme over the past three years, especially that relating to medical fees; and whether the Ministry can give a breakdown of the main complaints received and the action taken.
The Minister of State for Health Assist Scheme (CHAS), Dr Lam Pin Min, said that MOH is going to make a mandatory which says that the clinics will have to issue invoices with an itemised breakdown of fees and the details would be announced soon.
Dr Lam said that there have been almost 300 complaints, out of 5.8 millions CHAS claims, half were made against GP and dental clinics on CHAS between 2013 and 2015.
“About half of the complaints were related to charges at Chas clinics, including incorrect billing and high fees. Other complaints included operational issues resulting in incorrect subsidy, refusal by the clinic to provide itemised billing, customer service issues, and concerns over the professional practice of the doctor or dentist,” said Dr Lam.
The Agency of Integrated Care (AIC) has engaged the clinic involved to seek clarification for each complaints, said Dr Lam. Where the complaint was due to fees, AIC would review the bill breakdown and explain to the aptient if the fees were due to a lengthy consultation period or due to medications prescribes and the Agency would also work with the clinics if the bills need to be corrected.
Dr Lam said that two dental clinics were suspended. Audits revealed that both clinics have continuously filed claims that did not comply with rules and guidelines, including filling claims for procedures they did not perform. A few more clinics have also been referred to the police for investigation.
Dr Lam encouraged clinics to actively engage their patients. They are asked to display their common charges and provide itemised receipts upon request. He also encouraged patients to check their bills and alert the Ministry if they find anything unusual, especially since different CHAS clinics have different charges.
Mr Liang Eng Hwa, Member of Parliament for Holland-Bukit Timah GRC, also asked, due to high numbers of low-income Blue cardholders, if there were any plans on merging the Blue and Orange CHAS cards into one
“The cut-off for the household monthly income per person criteria set at S$1,100 is too low to qualify for the Blue card,” Mr Liang said. “Will the Ministry consider reviewing this threshold given that medical expenses have gone up. Are there plans to merge the Blue and Orange cards given that the Orange cards are not as popular?”
There are currently close to 1.4 million Singaporeans under the scheme. 400,000 of them are from the Pioneer Generation. Excluding the Pioneer Generation, close to 600,000 were Blue CHAS cardholders, while 400,000 were Orange cardholders.
Dr Lam said the Health Ministry will regularly review the subsidy quantum and scope of coverage of the Scheme, including its eligibility criteria.