Undergoing surgery, no matter
how minor, can be a scary
prospect. Adding to the fear
and anxiety is the worry
about costs.
While patients have the
process explained to them in detail, they
may not fully understand or remember
what they are told. For Singapore
General Hospital (SGH) patients,
once surgery has been confirmed,
a series of steps will be set in
motion to get them to think
about their planned procedure
and consider the costs involved.
“Once patients are scheduled
for surgery, an SMS with a link to
their surgery-related information in
Health Buddy (SingHealth's app for
patients) will be sent to them. Clicking
on the link takes them to the app, where
information about their pre-admission and
surgery appointments, estimated costs
and other information are available,” said
Ms Thirvchelvi Palaniappan K, Executive,
Pre-Operative Services, Division of Pre-Operative and Admitting Services (POAS),
SGH. “Patients can then consider and discuss
with their family members the ward and bed
type they prefer before they come to SGH for
their pre-admission counselling.”
Estimated costs
All aspects and details of the planned
procedure are included in the care cost form,
including the type of procedure that the
patient will undergo, the scheduled dates,
times and locations of various pre-surgery
tests and investigations, financial counselling,
post-surgery admission and estimated costs.
The form states what are included and
excluded in estimating costs, including the
average length of stay by patients undergoing
specific procedures. For example, patients
undergoing a total knee replacement usually
stay for three days.. The costs of specialised
investigations, however, are excluded, and
these are accounted for in the final bill.
To make it easy for patients to decide
on the ward type, there are tables showing
clear comparison of the estimated total
costs for A1, B1, B2 and C wards, rooms (normal and specialised, like intensive care
units), and treatments for those rooms,
said Ms Chelvi.
The estimates include the subsidies that
Singapore citizens and permanent residents
enjoy, as well as the amount they may claim
under their Medisave, private, employer,
government or Medishield schemes. Bills
are mostly settled through a combination
of Medisave, insurance and cash.
Patients opting for single or A1 class
beds must offer a letter of guarantee from
their insurer and place a cash deposit
equal to the estimated difference if the
amount in the guarantee does not
cover the estimated bill. If they
have outstanding bills from
previous surgeries and
treatments, they
should settle them
before surgery or
opt for other
ward types.
On the day
of admission,
patients
go through
another set of
examinations;
if they are found
to be unfit, the
operation will
be postponed or
cancelled. Tests and
investigations done
will have to be paid
in cash as Medisave
cannot be used.
Should surgery be
rescheduled to a
date within eight
weeks, pre-admission tests need not
be done again.
For common procedures at SGH, such
as knee replacements, giving birth and
some day surgeries, packages that take
the guesswork out of bills are available.
These are for patients who are unlikely
to suffer complications and need postsurgery
step-down care. Besides surgery,
the package includes standard lengths-of-stay,
consumables, physiotherapy and
post-surgery home visits.
If the patient faces complications during
surgery, requires specialised post-operative
care and further care in a step-down
facility, he will be charged on a nonpackage
basis that itemises services and
treatments. A detailed final bill will then be
sent to the patient a few weeks later.
Patients can change to another room
type after surgery, and charges will be
adjusted accordingly. Those who undergo
surgery as private patients can change
their status to subsidised for their postsurgery
outpatient consultations. They
will then be seen by any doctor in the
surgical team under the supervision of the
senior specialist. While private patients
can opt for their preferred attending
doctor, care in SGH, a teaching hospital,
is always team-based.
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