TPA fees not key reason for rising healthcare costs

[Voodooman]

Many doctors and medical professionals here. Any thoughts? This seems to be a hot topic recently. Recently, I went through a procedure and was darn pissed with how much I had to fork out from my own pocket and according to my doctor, my company's appointed TPA is to be blamed. True?

 

[Voodooman]

Lame or some truth to it?

 

Fee splitting erodes trust between doctors and patients

 

Fee splitting is frowned upon because it casts doubts on the medical profession ("Doctors barred from paying agents percentage of fees"; Dec 14).

 

There is no justification for fee splitting.

 

The lack of patients and business is not a good reason.

 

Similarly, medical practitioners must not pay landlords a portion of their gross income in order to secure more prominent shop units.

 

Discounts, special offers, free gifts, enticements and irresponsible advertising are equally frowned upon.

 

These gimmicks will adversely affect the medical practitioner-patient relationship.

 

For the sake of the public, the medical profession must stand firm and not waver.

 

Dr Hajime Ichiseki has missed this most important and fundamental foundation of trust that modern medicine is built upon ("Third-party agents helpful in matching patients to docs"; Dec 20).

 

Convenience cannot justify the use of third-party agents.

 

Some countries that have allowed kickbacks in their system are seeing a backlash, such as unsatisfied patients stabbing doctors.

 

Similarly, countries which rely heavily on third-party agents have the situation of residents being shuttled around town in ambulances trying to seek medical attention.

 

Primary care physicians are positioned as gatekeepers and navigators for the system. They know who to refer their patients to should the need arise.

 

Companies should not sacrifice the health of their workers by signing contracts that cannot deliver healthcare services the workers deserve.

 

Doctors must not forget the public they serve.

 

Leong Choon Kit (Dr)

[Lala81]

The ST health correspondent is widely disliked in medical field.

 

I think this fee issue applies more to the specialist than the average family GP. They definitely take a substantial cut, but if you don't have patients, LL lor.

 

Where anyone has a medical insurance covering normal consultation bills or employee medical benefits, there is already a separate factor added into the doctor-patient relationship.

[Evillusion]

The ST health correspondent is widely disliked in medical field.

 

I think this fee issue applies more to the specialist than the average family GP. They definitely take a substantial cut, but if you don't have patients, LL lor.

 

Where anyone has a medical insurance covering normal consultation bills or employee medical benefits, there is already a separate factor added into the doctor-patient relationship.

Who are these TPA? Never used one before as usually we will consult gp or poly and get referrals for specialist treatment.

[Lala81]

Who are these TPA? Never used one before as usually we will consult gp or poly and get referrals for specialist treatment.

 

basically companies or insurance companies pay a TPA to help do the admin work of finding clinics to cover their staff or their insurance patients, getting the billing done etc collecting from the doctors.

That's why they are called Third party administrators.

 

They obviously need to have a cut right. The problem now is that for specialists or for GP, some are not on a fixed fee system. So they earn more as the specialist charges more.

 

They are the ones that help provide patients to specialists and a substantial number of GPs nowadays. Cos many big companies all have health benefits/medical insurance coverage for their employees.

[Mason016]

basically companies or insurance companies pay a TPA to help do the admin work of finding clinics to cover their staff or their insurance patients, getting the billing done etc collecting from the doctors.

That's why they are called Third party administrators.

 

They obviously need to have a cut right. The problem now is that for specialists or for GP, some are not on a fixed fee system. So they earn more as the specialist charges more.

 

They are the ones that help provide patients to specialists and a substantial number of GPs nowadays. Cos many big companies all have health benefits/medical insurance coverage for their employees.

 

Wah! Can earn more money than lawyer and recession proof as well.  Starting my own TPA now!   

[Lala81]

Wah! Can earn more money than lawyer and recession proof as well.  Starting my own TPA now!   

 

it's also competitive lah. Companies don't give a shit about their employees unless really so disgruntled right. 

So these TPAs have to undercut each other and who they squeeze? The facking doctors lor.

 

So some GPs out there maybe earning like few dollars in consult fees to see one patient. 

 

And this SMC, what they do? They tell the doctors it's unethical to accept these agreements. When dear MOH should be the f**king ones to regulate these companies. Not regulate us...

[Evillusion]

basically companies or insurance companies pay a TPA to help do the admin work of finding clinics to cover their staff or their insurance patients, getting the billing done etc collecting from the doctors.

That's why they are called Third party administrators.

 

They obviously need to have a cut right. The problem now is that for specialists or for GP, some are not on a fixed fee system. So they earn more as the specialist charges more.

 

They are the ones that help provide patients to specialists and a substantial number of GPs nowadays. Cos many big companies all have health benefits/medical insurance coverage for their employees.

ah...i see! Most serves the private sector thats why i am never involved with these TPA. Good to know that these services exists.....better siam far far away! Thanks for the info, doc.

Wah! Can earn more money than lawyer and recession proof as well. Starting my own TPA now!

and i thought the era of middleman was going to buried... Edited December 22, 2016 by Eviilusion

[Kusje]

Actually whats the difference whether they regulate the doctors or the TPA? Telling doctors they can't pay % based commissions vs telling the TPAs they can't collect % based commissions? As long as there is compliance, there's really no difference right?

 

Maybe MOH is regulating the doctors because docs fall under their purview whereas TPAs might not.

Edited December 22, 2016 by Kusje

[Lala81]

ah...i see! Most serves the private sector thats why i am never involved with these TPA. Good to know that these services exists.....better siam far far away! Thanks for the info, doc.

and i thought the era of middleman was going to buried...

[Mason016]

ah...i see! Most serves the private sector thats why i am never involved with these TPA. Good to know that these services exists.....better siam far far away! Thanks for the info, doc.

and i thought the era of middleman was going to buried...

[Lala81]

Actually whats the difference whether they regulate the doctors or the TPA? Telling doctors they can't pay % based commissions vs telling the TPAs they can't collect % based commissions? As long as there is compliance, there's really no difference right?

 

Maybe MOH is regulating the doctors because docs fall under their purview whereas TPAs might not.

 

SMC can only regulate doctors. Precisely.

 

But the normal neighbourhood GP or pte specialist is the one that that has been suffering for the last 10-15 years under these companies. 

Sure you can be principled and don't accept lor. Then your clinic shut down, also your taichi mah.

 

Then don't blame doctors bidding sky high to get into clinics for prime locations lor.

Without footfall/human flow, how to survive.

[Evillusion]

it's also competitive lah. Companies don't give a shit about their employees unless really so disgruntled right.

So these TPAs have to undercut each other and who they squeeze? The facking doctors lor.

 

So some GPs out there maybe earning like few dollars in consult fees to see one patient.

 

And this SMC, what they do? They tell the doctors it's unethical to accept these agreements. When dear MOH should be the f**king ones to regulate these companies. Not regulate us...

These TPAs are normally runned by of-the-mill businessman or another doctor? Sometime these kind of blood-suckers bleeds both side of the fence, doctor and patients lan lan suck thumb and the company wash hands as its easier to outsource this services. I heard some company doctor really stinge on mcs....heard Te****K is like that wan!

[Mason016]

Actually whats the difference whether they regulate the doctors or the TPA? Telling doctors they can't pay % based commissions vs telling the TPAs they can't collect % based commissions? As long as there is compliance, there's really no difference right?

 

Maybe MOH is regulating the doctors because docs fall under their purview whereas TPAs might not.

 

Our doc is right, its a race to the bottom since these insurers who represent the companies which cover their employees with medical insurance will obviously take the GPs / specialists that charge the least i.e. cheaper, not necessarily better, and certainly not faster.

[Evillusion]

This middle men got do work one lah. The companies' HR and insurance companies got better things to do with their time, so they outsource.

can employ me mar......gibe me 4k/month i tiam tiam go see doctor everyday to get mc and intro to service the company!

[Lala81]

These TPAs are normally runned by of-the-mill businessman or another doctor? Sometime these kind of blood-suckers bleeds both side of the fence, doctor and patients lan lan suck thumb and the company wash hands as its easier to outsource this services. I heard some company doctor really stinge on mcs....heard Te****K is like that wan!

 

Some of them are run by some medical groups/doctors as well. I'm not that familiar with them as I'm not the boss 

 

I think everyone has a duty to manage costs. There's no easy answers on how to manage costs for both the companies to reduce abuse of their insurance or medical benefits.

[Mason016]

can employ me mar......gibe me 40k/month i tiam tiam go see doctor everyday to get mc and intro to service the company!

 

 I think got typo, I correct for you.

[Evillusion]

Haha wait long long.

 

Uber, Grab etc. are middleman as well.

 

 

Now I understand why I see lots of these chaps in business attire visiting my doctors because they certainly aren't representing pharmaceutical firms.

new business model everybody clamouring for their services.....this kind good for part-time but full-time i will think twice!

I think got typo, I correct for you.

kns.....4ks a month and everyday get mc u still want to up to 40k/month.....siao! Can drive for uber while earning 4k on the side job.....