There are more questions than answers regarding the payment of PCR tests for hospital admissions, as well as the uncertainty of how the decision of the Health Insurance Fund to pay BGN 60 of the cost of the PCR test for health insured persons with coronavirus symptoms will be implemented.
Pavlina Grigorova has many diseases and is disabled. To enter the hospital, she paid for a PCR test for BGN 130 and a quick test to have control tests performed in a laboratory. “I had to be hospitalized to change the course of treatment because of the withdrawal of some of the drugs I had been receiving at the Health Insurance Fund so far, and I was faced with the fact that I don’t have PCR, I come from the deep countryside. “Since I don’t have a PCR, I have to go home, collect money, pay for it in order to go back for hospitalization,” the woman told Horizont.
Coronavirus tests as a condition for hospital treatment are illegal, Penka Georgieva from Patient Organizations “Together with you” is categorical, where they already have many similar signals.
“It is not moral to ask for money for something that is not legally regulated, ie tests are illegal as a condition for admission to a hospital. Patients cannot be required to pay for such tests“, stressed Georgieva.
Nowhere in the Ordinance on Access to Medical Activity is it mentioned that these tests must be paid for by patients, and hospitals set this requirement.
The director of the Sofia Regional Health Inspectorate, Dr. Dancho Penchev, commented that medical institutions should not require additional payment for coronavirus tests. “Give me a signal, we’ll look into it,” he assured.
The Association of Municipal and Regional Hospitals issued a statement the state to pay for PCR tests for all patients.
The second problem that is emerging is that the Health Insurance Fund will pay BGN 60 for a PCR test of a health insured person, but after an examination by a personal doctor, who gives a referral to an infectious disease specialist. With this document you go to the doctor on duty at the Regional Health Inspectorate and he has the last word. The doctors in the health inspections do not have a contractual relationship with the Health Insurance Fund, pointed out to “Horizon” Assoc. Prof. Lyubomir Kirov, Chairman of the Association of General Practitioners
“I don’t think the doctors there are more competent and know patients better than we are, for example, or fellow infectious disease specialists and others who deal with patients on a daily basis. This decision was probably made to have some control over spending again. of the financial means, but from a purely professional point of view there is no logic in it “, Lyubomir Kirov thinks.
Thus regulated, the NHIF tests will not solve the problem, says Dr. Stoycho Katsarov, chairman of the Center for Protection of Healthcare Rights.
“The health insurance fund is obliged to pay the health insured for these tests, but the way it is done does not work.“, he sums up.
Funds from the National Health Insurance Fund will not be allocated for examination of patients who are screened before any other surgical or therapeutic intervention before admission to hospital, explained Dr. Veselina Koleva, head of a clinical laboratory at Tokuda Hospital.
“From both an epidemiological and a medical point of view, it is not very sensible to take a patient who is highly suspected of having this infectious disease through various institutions.“she said.
Hear all points of view in the sound files.
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