Saudi Gazette report

MADINAH — A number of patients have complained that some consultants refuse to examine patients who hold health insurance cards and insist that they pay cash, Al-Madina Arabic daily reported.

The patients said the doctors ignored their health condition and asked them to pay cash up front.

Health insurance experts say usually there is a contract between companies and the healthcare service providers but some hospitals ignore such contracts and ask patients to pay cash instead.

The patients, who were interviewed by Al-Madina, wondered whether such practice was legal.

Awad Al-Ahmadi, a patient, said some of the hospitals were only interested in making money and not fulfilling their healthcare role. “They are simply after profits regardless of the humanitarian aspects they should consider,” he said.

Ali Al-Harbi faced the same problem when he visited some of the big hospitals. “What is the use of a medical insurance if the hospital is not going to accept it?” he wondered.

Shahad Al-Marwani, a lawyer, said every patient had the right to lodge a complaint with the Council of Cooperative Health Insurance if a healthcare provider refused to serve him or her.

On the other hand, doctors too have rights and one of these rights is a doctor cannot be made to attend to a medical case against his will, Al-Marwani said.

“Therefore, if a patient files such a complaint, the council might simply advise to see another doctor or go to another hospital because there are several options available to him,” she said.

“The insurance council deals with healthcare service providers, meaning hospitals and polyclinics and does not have any control over doctors. But the patient can file a complaint with the council against the healthcare service provider. Usually, the council will not take any action in such cases. A complaint against a doctor should be lodged with the Ministry of Health,” she explained.

If a patient wants to see a doctor who charges SR500 and the insurance policy covers only SR200, the patient will be asked to pay the difference of SR300, she said.

Loay Abdo, an insurance consultant, said such cases could not be regarded as violation on the part of hospitals because a consultant who signed an employment contract with a hospital might have the right to demand that the patients pay cash but the consultants in such cases are normally well known and highly capable in their specialization.

“This is a strictly business relationship; the healthcare service provider will be looking for a successful doctor who can generate income for the hospital,” Abdo said.

“There is nothing unusual about some doctors refusing to accept insurance cards and prefer cash payments instead even if the hospital serves insurance patients,” said Adel Al-Issa, an insurance company spokesman.

“It is up to the patient to pay cash or find another doctor who accepts insurance,” he added.