Hospitals require capital for the smooth running and imparting the required care to the patient. However, recovery or settlement of bills still remains one of the most difficult practices for the medical fraternity. It requires more managerial mind rather than the medical mind.
In certain situations, it can be ideal to let go of the bill but the same can’t be applied every time, even if the patient is economically unstable to settle their bills, doctors or hospital staff should find different ways to assist patients in settling the bills. Taking regular advanced bills in certain situations could be one of the ways where the patient’s family doesn’t feel burdened by the total amount to be paid after discharge. The situation mostly drains out the doctor if the sudden death of the patient occurs, in such situations, many times doctors are at the receiving end where the family and other people think that the money invested by them is taken unnecessarily from patients. This misconception needs to be taken out of the patients.
Bills before the medical treatment in non-emergency situations:
It is ideal in situations when,
• Patients belonging to medical schemes are informed in advance that the cost of the treatment could be bared
• Patients who do not belong to a medical scheme are informed beforehand that they must pay a little amount of money in advance for the treatment
These situations are according to bioethical principles as if the patient decides to pay then the principle of autonomy is met while if the patient can’t afford the treatment the principle of beneficence, non-maleficence and justice are met.
It is ethically unjustified to refuse treatment if the patient cannot pay the dues in the following situations:
• Medical emergency
• A returning patient with a good record of payments
• Not linked with appropriate public health facility leading to the abandonment of the patient
Options which can help in the recovery of bills:
• Taking an advance cheque for some amount of bill so that legal option remains with the doctors
• If possible, through schemes and discounts, reduce a little bit of bill amount as sometimes little profit is better than no profit
• Use mediating options like insurance schemes, government schemes and policies which could benefit both hospital and patients
• If the situation worsens, a civil suit could be filed for recovery, however such methods require time and resources
• In certain situations where a patient has eluded from paying the bill for the first time, in that case, exercise the right to refuse the patient, although it is ethically incorrect, legally it is acceptable
It is, however, unacceptable to discontinue the treatment on the grounds on non-payment of bills, keeping the patient on the door of the Operation Theater. Ultimately it is your skill which determines how you ideally recover dues or settle the bill.
Source- Textbook on Medicolegal Issue