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为何在美华人“不敢”生病?原来医生有权独自开账单

2017-08-08 10:29:29   中国青年网

据美国《世界日报》报道,在美国许多华人“不敢”生病,因为相比于祖(籍)国本地医疗费过于昂贵,且很多人即使有健保,若买的是PPO计划,看医师自掏腰包的费用其实不少。

虽然很多人逆来顺受,乖乖支付医疗账单;也有华人指出,曾因医疗账单不合理,向健保公司咨询,才发现健保公司也会弄错,让原先被认为是投保人支付义务的账单,其实有一大部分须由健保公司支付。另有华人向医疗服务者求情,结果医疗费获得折扣。

保险经纪张念庭说,若病患认为医疗账单有问题,宜尽快向提供医疗服务的单位或健保公司请教,解决争议,以免账单被转给专门催收债务的公司,一不小心债务就会登记在个人信用纪录上,影响未来贷款等事宜。

读者刘艾登说,公司每个月替他一家五口支付PPO健保保费2000元(美元,下同),每月直接从薪水抵扣的健保自付部分是200元,相当于一年支付健保公司保费2.64万元。但月前其妻及儿子先后因健康出状况,分别透过正常医疗管道及急诊室就医检查后,仍收到三笔要求他支付的医疗账单,分别是1216.80元、902.17元及572.71元。

他一看金额这么高,决定搁置以不动应万变,没想到继续收到账单,其中572.71元账单还进了催债公司,对方来信说,若他在30天内不抗辩,代表该笔债务就是合法。

他一时心急曾致电催债公司表示,付不出那么多钱,解释儿子急诊时他除当场支付100元费用外,医院另外向健保公司要求支付4747元,健保公司将这笔费用调整为2610.85元,并已支付1608.69元后。但医院还要他自付902.17元,不了解为什么急诊时短暂露面的医师这部分,也要他另外自付572.71元。催债公司工作人员于是同意将债务降价至400.89元,并表示这是最大折扣,不可能再降。

刘艾登当下响应需要考虑,并以这几笔医疗账单似有超收嫌疑致电健保公司询问,被告知PPO计划每位投保者都有500元自付额,500元以外的医疗费,只要源自健保公司网络内的医疗服务公司,健保公司才会支付80%医疗费,投保人支付20%医疗费。

数学很好的刘艾登马上发现,儿子的两笔账单有问题,因为儿子医院账单那部分,已将500元自付额算进去,医师那部分账单不应该再要求他支付另外的500元自付额。健保公司于是道歉说,医师那部分账单确实有误,针对医师要求的816元,保险公司不该只支付243.29元,并要求他负担剩余的572.71元,健保公司其实应该支付80%费用,让他的账单一下子从572.71元降至163.2元,比原来催债公司同意他支付的金额还要低很多。

“其实医疗账单在某种程度,是可以与医疗服务单位商议降价,但绝对不要拖”,张念庭指出,不久前即有一位学生的监护人气急败坏地拿着急诊室账单请他帮忙处理,原来是对方监护的一名学生因为晚上7、8点时和别人打闹,以致从胳博到手掌都磨破了并有流血,监护人怕有闪失送急诊室看诊。之后账单来了,医院及医师两笔账单分别是2000多元及300多元,那位监护人只付了300多元账单,对2000多元账单感到苦恼。

他于是致电医疗服务单位,寻求2000多元账单细目。他以该位受伤孩子只是皮肉伤,急诊室未做断层扫描或麻醉等大动作等理由,说服对方同意该名监护以信用卡当场付清医疗费,同意降价至400多元。

针对医疗账单争议,前医院院长张志坚说,美国医疗制度和中国不同,若是透过急诊看病或住院治疗,病人要有一个观念,那就是医院和医师分别都有权利向病患索取医疗服务费,若介入的医师不只一位,假设除了小儿科医师,尚有麻醉科或其他科医师会诊,每位医师都有权利单独开出医疗账单。(王善言)

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