“A couple of rotten apples and oranges does not mean that the rest in the basket are bad,” said Dr Low Lee Yong, the chief executive of MHC Asia Group, a third-party administrator (TPA) which manages medical benefit schemes for insurers and corporate clients.

He was speaking in response to the recent uproar by healthcare professionals of the unfair practices of some TPAs in the industry, who are concerned over the ethical practices of high charges imposed by administrators.

Dr Low: TPAs play an important role in healthcare

Doctors have been concerned of late regarding the fees imposed by TPAs, apprehensive that administration fees calculated based on patient charges would put them at risk of the unethical practice of fee-splitting. Other cries of dissatisfaction include that the high charges have eaten into their profit margins.

Chee Hong Tat, the Minister of Health for State has said that the ministry is considering regulations on the disclosure of TPA administrative fees, particularly if said fees are imposed on patients. Additionally, new ethical guidelines that are due to take effect next year, state that fees paid by doctors to administrators should be founded on work performed by the TPAs, and not calculated from patient fees charged by doctors.

Despite these concerns, Low has said that TPAs play a “pivotal role” in managing healthcare costs and simplifying the administrative process of medical benefit programmes of insurers.

TPAs should play role to make private healthcare accessible by citizens

While some provide “legitimate services” to assist in healthcare services and costs, the other functions primarily as a referral services similar to a medical concierge and act merely as an “introducer to the specialists”, Low added.

As a result, such specialists “may inadvertently pass on the cost charge by these parasitic providers” to patients or those under the Integrated Shield plans.

Transparency is good for healthcare, Low said, adding that disclosure of fee arrangements should be made upfront to patients.

Another TPA group, Alliance Medinet, has assured that it maintains patients’ quality of care by ensuring the professional autonomy of doctors.

“In our programmes, we do not restrict or interfere with doctors’ professional decisions, as long as they are based on good medical evidence,” said a spokesperson, adding that with private healthcare becoming increasingly costly, “a responsible TPA has a role to play, together with other stakeholders, to find a solution to make private healthcare accessible to more Singaporeans.” MIMS

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