GPs: Refine claims system for patients

PHOTO: GPs: Refine claims system for patients

[Above: Dr Yap Eng Chew shows the computer program he uses to submit Primary Care Partnership Scheme claims.]

By Teh Jen lee

Some doctors are not worried about the increase in administrative work that will come about from the recently announced changes to the Primary Care Partnership Scheme (PCPS).

But others say it will eat into valuable time.

The scheme allows eligible patients to pay subsidised rates, similar to those charged by polyclinics, when they go to participating private clinics.

Dr Yap Eng Chew of Yap Medical Clinic in Toa Payoh Lorong 4 said administrative work is not a hassle thanks to a computer software that links to the Ministry of Health's (MOH) reimbursement system.

"The Crimson Logic computer program costs me about $100 a month and I use it only to make PCPS claims although it can be used for other aspects of clinic management," said Dr Yap, whose clinic sees one or two PCPS patients every day.

He has been a general practitioner (GP) for 10 years and he switched to the computer system within a few months of joining the PCPS.

"It is much easier than submitting paper claims. My clinic assistant does the keying in of the relevant information, a process that takes less than a minute per patient.

"Within a few weeks, we get the reimbursement from MOH through our respective medical clusters, which happens to be NHG (National Healthcare Group)," said Dr Yap.

But he acknowledges that other doctors who see more PCPS patients may feel bogged down by the administrative work required.

Always an issue

Always an issue

Indeed, another GP in Toa Payoh, who declined to be named, said "administration is always an issue" as he sees five or six patients under the scheme each day.

This is because his clinic is in an area where the residents are older and not so well-off.

The doctor, who has been a GP for 15 years, said: "I see about 150 patients each month under PCPS.

The claims have to be done within a month of the patient's visit.

"I do the administration myself whenever I can find the time because my nurse has other work to do."

His clinic has been on the PCPS for about two years.

The doctor said: "I know clinics that did not join PCPS because of the administrative work.

"I did because my patients do appreciate it. They don't have to wait hours at the polyclinic and then get a doctor who can't speak their dialect."

However, submitting the claims online takes him at least two hours each month.

"That's time I don't have, to be honest. Unfortunately I can't think of any other way," he said. He added that multi-clinic practices may be able to hire administrators to handle such tasks, but stand-alone clinics like his cannot afford them.

Nonetheless, he agreed that the changes would be helpful to those who are in need.

Madam Chin Ah Moy, 63, who suffers from high blood pressure, will be eligible next year when the changes kick in.

She said in Cantonese: "The good thing about GP clinics is that they open late, so we can go there if there is an emergency.

"With the subsidy, we won't have to worry so much about the cost."

On Monday, Dr Chong Yeh Woei, president of the Singapore Medical Association (SMA), expressed some concern about the paperwork and the administrative hurdles associated with the changes.

He told The New Paper: "The SMA supports and is very encouraged by the Government's attempt to increase PCPS coverage.

"It is noted that the current system handles a relatively smaller pool of 30,000 out of an eligible base of 87,000.

"Therefore, we need to allow time for the system to be retooled to cope with the much larger workload with 710,000 potentially eligible, an expansion of about nine times the current load."

He added that SMA will support and cooperate with MOH to offer feedback and work with its members to help refine the scheme as it rolls out in the next few months.

Madam Woo So Har, 73, who has not joined the scheme although she is eligible, hopes the process of application can be simplified.

She said in Cantonese: "The clinic I go to does not have the application form. They should have them so it's easier for us. I pay more than $70 a month for blood pressure and cholesterol medicine."

Under the new scheme, she may save up to $300 a year.

She added: "Only one of my children supports me. I would like to get on the scheme, but it seems so troublesome, especially since I can't read."

Changes to scheme

Changes to scheme

1. More relaxed age and income criteria

Before: Must be at least 65 years old, with per capita monthly household income of no more than $800.

After: Age criterion lowered to 40, income criterion raised to $1,500.

2. New tier system

Tier A is for those with $900 or less per capita monthly household income. They pay cheaper rates for: - Coughs and colds; - Standard dental treatments; - Chronic diseases (diabetes, hypertension, lipid disorders, stroke, asthma, chronic obstructive pulmonary disease, schizophrenia and major depression); - From November, dementia and bipolar disorder will be included.

Tier B is for those with $901 to $1,500 per capita monthly household income. They get cheaper rates only for chronic diseases and dental procedures.

3. More subsidies for chronic conditions

Before: $60 per visit (annual cap of $360 depending on severity).

After: - $80 per visit (cap is $480) for Tier A. - $50 per visit (cap is $300) for Tier B.

Source: MOH

This article was first published in The New Paper.