Payment issue forces hospitals to stop service under health card scheme – Pakistan

ISLAMABAD: A number of hospitals have stopped providing services under the government’s health card program due to payment issues.

Even the Pakistan Institute of Medical Sciences (Pims) Heart Center has stopped implanting stents in the past week as the vendor refused to supply stents due to non-payment of bills of over 100 million rupees.

On the other hand, Ministry of National Health Services spokesman Sajid Shah said he had not received any complaints about non-payment of bills and that if citizens have any problem, they should contact the Ministry.

Under the Qaumi Sehat card and the Sehat Sahulat program, citizens can avail medical facilities including open-heart surgeries, stent insertion, cancer management, neurosurgical procedures, burn management, accident management, dialysis, intensive care management, childbirth, caesarean section and other medical and surgical procedures up to Rs 1 million per family, per year.

Pims Cardiac Center refuses to implant stents; spokesperson says citizens should complain to department

The holder of the health card can benefit from the installation of more than 600 approved hospitals in the country.

Since the launch of the health card scheme in 2015, the State Life Insurance Corporation of Pakistan has been handling the cards and last year they again won the contract for the next three years (2022 to 2025).

Currently, 100% of the population of Islamabad, Punjab, Khyber Pakhtunkhwa, Azad Jammu and Kashmir and Gilgit-Baltistan are entitled to free treatment.

Talk to Dawnowner of Rawal General and Dental Hospital (RGDH) in Islamabad, Khaqan Waheed Khawaja, said a number of private hospitals, including his hospital, had stopped providing care under the health card health.

“First of all, we don’t receive payment for the treatment. Second, the amount for each of the procedures is too little. The health card provides 15,000 rupees for childbirth, but this amount is not enough, therefore a number of private hospitals have stopped providing care under the health card,” a- he declared.

Responding to a question, Mr Khawaja said that during the current week he had held a meeting with representatives of private hospitals and it was decided that they would meet again on Tuesday (April 5). ) to make a final decision on health cards.

“I think the government should not have provided the facility to 100% of the population, rather it should have been extended only to the disadvantaged,” he added.

Shahid Nazir, a resident of Islamabad, while talking to Dawnsaid he took his 65-year-old brother-in-law, Mohamad Asghar, to Pims Cardiac Center but was told by doctors that the stents could not be implanted because the vendor had stopped supplying them with the stents.

“Doctors told me they had implanted a number of stents over the past few months, but now the seller has stopped supplying stents and other tools for the procedures because their bills haven’t been paid. “, did he declare.

The president of the Pims Young Doctors Association, Dr Haider Abbasi, during a conversation with Dawnsaid he himself had seen a number of doctors refusing to treat patients under the health card scheme.

“I personally did a number of endoscopies under the health card and then learned that the bills had not been paid,” said Dr Abbasi, who is a gastroenterologist.

When contacted, the Director of Pims Hospital, Dr. Khalid Masood, said he had personally resolved Pims’ problem and made partial payment to the vendor who had started supplying stents.

The hospital would resume service under the health card program and begin inserting stents from Monday, he said, adding that “part of the amount was paid to the vendor and now does not anyone can go to the hospital for services.”

He said he was appointed hospital director two and a half months ago and four days later “I decided to provide services under the health card program”.

According to the procedure, once a patient receives treatment, the bill is sent to the insurance company and the company takes 28 days to verify and settle the bill. There was a problem at the Cardiac Center, but I personally looked into it and part of the amount was paid to the supplier, which allowed the supplier to resume the supply of stents, ”he said.

“So far, we have performed more than 1,800 procedures under the program at Pims. Now we will computerize the health card system, which will improve the service,” he said.

“There are confusions; people want outpatient treatment (OPD) but the card only covers hospitalization. Also, a number of people bring their wife for treatment or delivery, but they don’t get it because they don’t change their wife’s marital status in the CNIC, so the system shows that they are not married and can only be treated if their parents are entitled to it. I suggest that people change the marital status of their wives with the National Database and Registration Authority after marriage,” Dr Masood said.

Talk to DawnDepartment of National Health Services spokesman Sajid Shah said he had not received any complaints about non-payment of bills.

“It’s a huge system and there are more than 20 hospitals incorporated in Islamabad. If one hospital refuses to provide treatment, patients have to go to another hospital. We are constantly monitoring the bills, checking the amount claimed by a hospital and let’s check whether the request is real or not. If people have complaints, they should contact the Ministry of Health and their problems will be solved,” he said.

Posted in Dawn, April 3, 2022

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Elaine R. Knight