• About Us
  • Archives
  • SWG Registration
Samrack Media
Mahiga Homes
  • Home
  • ALL NEWS
  • Diaspora
  • Africa
    • AFRICA
    • KENYA
  • BUSINESS
    • BUSINESS
    • INVESTMENTS
    • REAL ESTATE
    • TECHNOLOGY
  • Politics
  • Health
    • HEALTH
    • EDUCATION
  • Religion
  • People
    • PEOPLE
    • LIFESTYLE
    • RELATIONSHIPS
  • Obituaries
  • Videos
  • Events
No Result
View All Result
  • Home
  • ALL NEWS
  • Diaspora
  • Africa
    • AFRICA
    • KENYA
  • BUSINESS
    • BUSINESS
    • INVESTMENTS
    • REAL ESTATE
    • TECHNOLOGY
  • Politics
  • Health
    • HEALTH
    • EDUCATION
  • Religion
  • People
    • PEOPLE
    • LIFESTYLE
    • RELATIONSHIPS
  • Obituaries
  • Videos
  • Events
No Result
View All Result
Samrack Media
No Result
View All Result

How hospitals exploit insured patients

samrack by samrack
June 6, 2018
in Africa, Business, Diaspora, Kenya, Kenya Diaspora News, News
A A
0
How hospitals exploit insured patients
Share this
FacebookTwitterPinterestEmailWhatsAppLinkedIn
Patients wait to be attended to. Hospitals are on the spot for exploiting insured patients. PHOTO | FILE | NATION MEDIA GROUP 

How hospitals exploit insured patients

Kenyans are paying through the nose for hospital services because health providers inflate medical bills for those paying via insurance, the Nation can reveal.

Excess diagnostic tests, exaggerated prescriptions and unnecessary admissions are some of the tricks medical personnel use to fleece Kenyans seeking treatment.

A doctor who spoke to the Nation on condition of anonymity said that clinicians in private hospitals are given monthly financial targets in order to keep their jobs.

This forces them to be creative in how they manage their patients to ensure they ‘milk’ as much as they can from the insurance cover.

“Some of these targets run up to millions of shillings per month. So the doctors are forced to order laboratory tests and prescribe unnecessary medicines. In addition, they are quick to admit patients even when the patient is in no need of further observation. The goal is to make as much money as possible from the patient,” he said

Related Content

  • Group suspected of running insurance fraud scheme

As additional incentives, clinicians are sometimes paid a commission based on how much they have contributed to the hospital’s earnings.

For instance, during child birth, hospitals assign a team of physicians and specialists to be present, and each of them attracts a cost.

“A typical uncomplicated delivery will be attended to by a gynaecologist, paediatrician and a neo-natal specialist, even in cases where it is clear that not all these people need to be present,” he said.

Baraka, not his real name, is a civil servant working in Meru County. He says that when his wife went in to deliver their last born child, she spent an extra three days at the hospital, racking up the hospital bill because the doctors insisted on keeping her “under observation” despite the fact that they had provided no evidence that additional medical care was necessary for either the baby or the mother.

EXTRA THREE DAYS

“My wife gave birth on the first night of her admission and, by the end of day two, all tests showed that she and the baby were healthy. Yet the doctors insisted on keeping them in the hospital for “observation.” We ended up spending an extra three days, with no meaningful procedures,” he said

He added: “In the end, I demanded to take my family home, despite protests from the doctors and their insistence that I sign a release form indicating that my wife was being discharged in contravention of doctors’ orders.”

He ended up paying Sh86,000  for a normal delivery with no complications.

Double tier pricing, a practice where medics charge patients differently depending on what mode of payment they use, has been flagged by insurance providers as one of the leading causes of insurance fraud in Kenya.

ULTRASOUND

“We have had to strike off some clinics from our list of approved health providers because they are too dishonest with their billing. For instance, we have had patients billed for ultra sound when the hospitals they attended had no ultra sound machines.

In other cases, patients are forced to undergo blood and urine tests for straightforward coughs and afterwards are saddled with drug prescriptions a mile long,” said a source from Minet Insurance who requested anonymity as he is not authorised to speak to the media.

To attempt to arrest this trend, Minet has introduced a pharmacy concierge service that supplies medicines to its clients at a reasonable cost.

“Once a doctor prescribes the medicine, you take a picture of the prescription and send it to us via email or WhatsApp.

LOWER COST

Our in-house pharmacists look at them and determine whether they are legitimate or not. If they are, we deliver the medicine at a lower cost,” said the source.

The insurance regulator has however defended double tier pricing by hospitals saying that what hospitals charge insured patients is separately negotiated with the providers, which allows hospitals to bill more to account for the amount of time it takes to pay out the insurance billings.

“Paying for medical services with an insurance card is akin to buying a product using hire purchase, whereby the consumer is ultimately charged more as they take longer to pay compared to someone who pays cash. The disparity between cash and insurance card billing is inevitable,” said Insurance Regulatory Authority head of Corporate Communications Noella Mutanda.

She denied that the regulator had received reports of insurance fraud by hospitals.

Source: Daily Nation

 

 

Tags: How hospitals exploit insured patients
Previous Post

Kenya Among Countries with largest number of African immigrants

Next Post

A look at major plane crashes in Kenya

Related Posts

Kenya Airways Subsidiary Fahari Aviation To Receive Embraer Eve eVTOL Aircraft From 2026
Business

Kenya Airways Subsidiary Fahari Aviation To Receive Embraer Eve eVTOL Aircraft From 2026

June 22, 2022
Kenyan Nurse Given a Three-story Home in Lebanon, Pennsylvania After Volunteer Work
Diaspora

Kenyan Nurse Given a Three-story Home in Lebanon, Pennsylvania After Volunteer Work

June 22, 2022
Uhuru’s Daughter Ngina Kenyatta Ties the Knot in a Traditional Wedding Ceremony
Diaspora

Uhuru’s Daughter Ngina Kenyatta Ties the Knot in a Traditional Wedding Ceremony

June 22, 2022
Untold Stories of How Thika Road Estates Got Their Names
Business

Untold Stories of How Thika Road Estates Got Their Names

June 22, 2022
President Uhuru Rejects To Assent Into Law ICT Bill, Opting To Send It Back To Parliament For Review
Kenya

President Uhuru Rejects To Assent Into Law ICT Bill, Opting To Send It Back To Parliament For Review

June 22, 2022
Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs, Nairobi county.
Business

Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs, Nairobi county.

June 22, 2022
Next Post
A look at major plane crashes in Kenya

A look at major plane crashes in Kenya

Please login to join discussion
Job Openings Below is a list of current job openings at Northeast Clinical Services, Inc.. Please click on an opening in the list to view details and apply. Job Openings Below is a list of current job openings at Northeast Clinical Services, Inc.. Please click on an opening in the list to view details and apply. Job Openings Below is a list of current job openings at Northeast Clinical Services, Inc.. Please click on an opening in the list to view details and apply.
ADVERTISEMENT
ADVERTISEMENT

Latest News

Kenya Airways Subsidiary Fahari Aviation To Receive Embraer Eve eVTOL Aircraft From 2026

Kenyan Nurse Given a Three-story Home in Lebanon, Pennsylvania After Volunteer Work

Uhuru’s Daughter Ngina Kenyatta Ties the Knot in a Traditional Wedding Ceremony

Untold Stories of How Thika Road Estates Got Their Names

President Uhuru Rejects To Assent Into Law ICT Bill, Opting To Send It Back To Parliament For Review

Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs, Nairobi county.

George Wajakoya’s Running mate: Who is Justina Wangui Wamae

IEBC set to make corrections to voters’ register

Kenya cannot ban Mitumba without upsetting the US,Just ask Rwanda

Transition/Death Announcement of Francis Kagumba Mwenenia (Father to Pastor Naomi Kagumba (Lowell,MA ) of St Stephen’s Church Dracut,MA

We are grateful for your monthly or one-off donations To Samrack Media: Cash App No: 781-888-8770 $SAMRACK001

Money

New Digital Skills Helps Unemployed Kenyan Youth Earn In Cryptocurrency

New Digital Skills Helps Unemployed Kenyan Youth Earn In Cryptocurrency

by samrack
November 19, 2021
0

New Digital Skills Helps Unemployed Kenyan Youth Earn In Cryptocurrency This week sees the launch of a new initiative to equip...

A simple guide to Government Bonds investing in Kenya

A simple guide to Government Bonds investing in Kenya

by samrack
September 17, 2021
0

A simple guide to Government Bonds investing in Kenya A treasury bond (T-bond) is a medium term to long term...

Politics

Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs, Nairobi county.

Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs, Nairobi county.

by samrack
June 22, 2022
0

Police in Nairobi recovered 22 firearms and 565 rounds of ammunition during an auction mission on Tuesday in Kilimani suburbs,...

George Wajakoya’s Running mate: Who is Justina Wangui Wamae

George Wajakoya’s Running mate: Who is Justina Wangui Wamae

by samrack
June 9, 2022
0

She has risen to prominence, following her selection as a running mate for one of the only four presidential candidates...

  • About Us
  • Archives
  • SWG Registration

© 2021 SAMRACK - Diaspora News & Updates; design by: Samrack.

No Result
View All Result
  • Home
  • ALL NEWS
  • Diaspora
  • Africa
    • AFRICA
    • KENYA
  • BUSINESS
    • BUSINESS
    • INVESTMENTS
    • REAL ESTATE
    • TECHNOLOGY
  • Politics
  • Health
    • HEALTH
    • EDUCATION
  • Religion
  • People
    • PEOPLE
    • LIFESTYLE
    • RELATIONSHIPS
  • Obituaries
  • Videos
  • Events

© 2021 SAMRACK - Diaspora News & Updates; design by: Samrack.

Page generated in 1.476 seconds. Stats plugin by www.blog.ca