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IP insurers will have more specialist doctors on panels

This gives 2.85 million policyholders more options; resolution platform launched

The 2.85 million people here with Integrated Shield Plans (IPs) will have a wider choice of specialist doctors on the panels of the seven insurers that offer such plans.

Patients, insurers, doctors and medical institutes with grievances can also turn to a new resolution platform set up yesterday.

The Ministry of Health (MOH) announced these changes as part of its move to address issues related to MediShield Life-linked private health insurance.

Policyholders and doctors alike have complained about the small number of specialists on the insurers' panels.

At the start of this year, the panels of the seven insurers had between 190 and 409 private sector doctors on them.

Now, four of them - AIA, Aviva, AXA and Great Eastern Life - have committed to having at least 500 specialists on their panels by the end of this year; NTUC Income and Prudential will have at least 450; and Raffles Health Insurance will have 250. Some have already reached their targets.

As at end-August, 79 per cent of the 1,235 eligible private sector specialists were on at least one insurance panel, up from 70 per cent at the start of the year.

Insurance panels are important as the 1.71 million policyholders who have riders to cover part of their portion of the bill have certain perks, such as paying no more than $3,000 a year of their bills, if they use doctors on the insurer's panel.

The cap may not apply if they use non-panel doctors.

COMPLAINTS

But there have been complaints that a small panel gives patients limited choice. Some doctors have also complained about being rejected by insurers. Most insurers say they want doctors with at least five years' experience on their panels.

MOH set up a Multilateral Healthcare Insurance Committee in April to look at how to better address disputes, and expand the size of IP insurer panels. The ministry has accepted the committee's recommendations.

IPs, which are integrated with the basic MediShield Life, cover patients for private medical treatments, so they need to pay only the annual deductible - which ranges from $1,500 to $5,250 depending on the class of care and age of the patient - and 10 per cent of the rest of the bills.

To slow down runaway healthcare costs, MOH imposed a minimum co-payment of 5 per cent of the bill, subject to a minimum cap of $3,000 a year for patients with riders bought after March 8, 2018.

Also announced is a new resolution platform that insurers, doctors, healthcare institutions and policyholders can turn to for help in case of clinical-related disputes. Called the Clinical Claims Resolution Process, it is voluntary, so all parties must agree to participate.

Should a doctor be found to have overcharged or over-serviced, the Academy of Medicine will provide guidance, with a senior practitioner in the same field providing counselling to help the doctor, said Professor Teo Eng Kiong, master of the academy.

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MEDICAL & HEALTH