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Thursday, May 18, 2006

Why prior approval is useful

I wish to share an experience involving someone I know. It illustrates the importance of getting prior approval for expensive medical treatment.

Mr Koh went to see a specialist for a medical condition. The specialist carried out some complicated tests. He told Mr Koh that his condition is serious and needed to be treated immediately.

Mr Koh signed the consent letter and was operated. He was discharged a few days later. He received a bill for more than $30,000. Mr Koh was not insured.

Mr Koh consulted his personal doctor. The doctor told him, "Mr Koh, you are already 80 years old. This type of medical condition is not serious. The operation is not necessary for a person of your age. Why did you agree to be operated?"

Mr Koh paid the bill. He decided not to pursue the matter.

Lesson: If Mr Koh is insured and has to consult his insurance company, he will be able to get a second opinion. In fact, the specialist will not dare to recommend an unnecessary operation, as he might be questioned.

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