Question to general practitioner Maarten: Surgery in Thailand not reimbursed due to lack of referral
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:
- Age
- Complaints)
- History
- Medication use, including supplements, etc.
- Smoking, alcohol
- Overweight
- Any laboratory results and other tests
- Possible blood pressure
Photos and attachments can be sent to [email protected] everything can be done anonymously, your privacy is guaranteed.
Dear Martin,
I have been hospitalized for a kidney stone operation, this operation is reimbursed by the Dutch health insurance. In this operation they placed a double J stent, but it had to be removed again after 1 month, so another operation. However, this was not reimbursed because a referral from a Dutch or specialist is missing.
Does anyone have an idea how to get such a referral from a Dutch specialist or general practitioner? Because the Thai specialist probably doesn't seem skilled enough. Perhaps general practitioner Maarten Vastbinder has experience with this.
Thanks in advance for your responses.
Regards,
F.
****
Dear F,
Unfortunately I have no experience with this. Not even in Spain at the time. Perhaps the readers know more/
It seems strange to me that the insurance makes this requirement, since this is probably a fairly urgent procedure. Normally, a J stent can be left in place for two weeks to three months before being replaced if necessary. However, it must be done sooner in the event of closure.
You may need to notify your insurance company that the stents were clogged, if that was the reason for the replacement.
Sincerely,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).
What I know is that abroad you ALWAYS have to ask permission from your health insurer or travel insurer for an admission and procedure in hospital, unless it is very urgent and life-threatening. Also stated in the policy conditions.
Getting a referral afterwards will be difficult, I'm afraid. Write a neat letter to your health insurer with a thousand apologies and ask for a leniency arrangement
Can only tell my own experience.
Am insured with VGZ with country of residence Thailand.
About 5 years ago I had a colonoscopy done.
After I came to, I had to quickly get dressed, put in a wheelchair and go downstairs.
Didn't know what for yet, asked for it they wanted me a Ct. Have a scan done.
Had then said, ho ho wait a minute, my insurance has given a bank guarantee for the Colonoscopy.
That is arranged by us, they would have done.
The results of my oncologist showed, she received a message from the doctor who did the colonoscopy, while I was still in a coma, that it was not good, I think but I'm not a doctor, they removed a few polyps and. sent to Bangkok.
That's why when she got that message, she immediately wanted me to get a Ct. had to make a scan.
After 2 weeks the results of the Lab came, and my Oncologist made another appointment for me, for Colon Scopi, after 3 months.
I sent this to Maarten, that was good now again this year after 4 years, canceled last year because of Corona.
Maybe Maarten knows more, but I think to make a Colonoscopy it should be done by an Oncologist for me.
Maybe a referral letter from another doctor, and let him make a medical report.
Hans van Mourik
I have had 5 colonosopies in the last few years. This is a viewing test and is carried out by an gastroenterologist who also removes any polyps.
I was never put to sleep doing that. Always wash under local anesthesia.
If cancer is diagnosed and pieces of the intestine have to be removed, that will be a different story.
Let that Doctor make a medical report, to your assurance, that it is necessary.
Me as a customer of the RAM, do it like this.
Both at the Oncologist for a CT. Scan, Colonscope, or at the Ophthalmologist for injection.
With my stroke that I had, by my Neurologist, for a Ct.Scan, with Low Doses.
Then it should be fine.
Hans van Mourik
PS. At my colon cancer surgery in 2013.
Which had to be done immediately, my oncologist made a medical report for which my insurance.
For Ct.or Ct. Pet scan and Chemo, she does that too, then gets an apointment from her.
I send it to my insurance company, and let the insurance company sort it out with her.
(Am not a doctor.)
After that, my insurance company receives an e-mail that they have sent the bank guarantee to the relevant person.
Hans van Mourik
F, to what extent does it make sense/common for that stent to ever need to be removed?
If that is customary, the insurance company asks for the known way and their attitude is very formal. Ask the treating doctor in Thailand for a note in which he/she explains in English why the stent had to be removed.
Response to Ronny.
I had cancer and had surgery.
In 2013
Had a colon Scopie 8x soon again on 02-04-2022.
Does my insurance still have to ask for a bank guarantee, but does that start March.
Have an apointment from my Doctor.
All those 8x under anesthesia for 2 to 3 hours in a coma.
I'm not a doctor so I don't know why.
Hans van Mourik