finacial information for obstetric patients - Parkway Pantai

PACKAGE FINANCIAL COUNSELLING FORM – MATERNITYNon-singleton deliveries (e.g. twins, triplets and multiple deliveries) are not entitled to the maternitypackages. Packages initially accorded will be withdrawn in the event of non-singleton deliveries.PackageCodePackage DescriptionLengthof Stay(Days)PackagePrice ($)Medisave ClaimableLimit ($) #^(For Daily Hospital &Operation Claims)8001170001 Normal / Assisted* Vaginal Delivery(2BD)TOSP Code: SI035U or SI038U8001180003 Normal / Assisted* Vaginal Delivery(1BD)TOSP Code: SI035U or SI038U8001170005 Normal / Assisted* Vaginal Deliverywith Epidural (2BD)TOSP Code: SI035U or SI038U8001170007 Normal / Assisted* Vaginal Deliverywith Epidural (1BD)TOSP Code: SI035U or SI038U8001170101 Caesarean Delivery – Elective (2BD)TOSP Code: SI036U8001170103 Caesarean Delivery – Elective (1BD)TOSP Code: SI036U8001170105 Caesarean Delivery – Emergency (2BD)TOSP Code: SI036U8001170107 Caesarean Delivery – Emergency (1BD)TOSP Code: SI036U2 1,850.00with 7% GST 1,979.502 2,600.00with 7% GST 2,782.002 2,150.00with 7% GST 2,300.502 2,900.00with 7% GST 3,103.003 3,200.00with 7% GST 3,424.003 4,100.00with 7% GST 4,387.003 3,700.00with 7% GST 3,959.003 4,600.00with 7% GST 4,922.002,150.002,150.002,150.002,150.003,500.003,500.003,500.003,500.00* Assisted vaginal delivery is defined as the use of forceps or vacuum pump to aid in delivery.#If baby requires separate admission for medical reasons, Medisave claimable limit for the baby’s admission is $450 per day.^ Up to an additional $450 for antenatal charges can be claimed if the couple is eligible for the Medisave Maternity Package.Original invoices for antenatal care must be submitted to the Business Office upon admission to qualify.PACKAGE INCLUSIONS:2 or 3 days of general ward accommodation (1BD or 2BD) and daily treatment feeMedical and surgical supplies within normal boundsNursing care and common ward proceduresBCG and Hepatitis B vaccination (1 st dose)Basic Baby Screen [package of blood tests to test for G6PD (glucose-6-phosphate dehydrogenase) deficiency,determine ABO blood type, and determine serum TSH (thyroid stimulating hormone) levels]For Normal / Assisted Vaginal Delivery:Delivery facility and CTG (cardiotocographic) monitoringFor Normal / Assisted Vaginal Delivery with Epidural:Delivery facility and CTG (cardiotocographic) monitoringIV (intravenous) set and epidural drugsFor Caesarean Delivery (Elective or Emergency):1hr 45 min surgery time in the major operating theatre1hr 45 min use of general or regional anaesthetic15 min use of recovery roomOperating theatre (OT) services

PACKAGE EXCLUSIONS:Other types of accommodation (e.g. deluxe, VIP etc.)Specific consumables (e.g. abdominal binder, antibiotics)Newborn hearing screeningPhototherapyOT surcharge for horoscopic LSCS (2000 hours – 0730 hours)Use of the operating theatre (OT), recovery room, and general anaesthetic in excess of the stipulated timeCardiovascular laboratory (CVL) services and radiological contrastsElectrocardiograms (ECGs), treadmill tests, and diagnostic imaging services (e.g. CT, MRI, ultrasound,echocardiography [TEE], PET, nuclear medicine, X-rays, etc.)Dialysis and oncology servicesAll laboratory tests and services, including blood transfusion products and services, histopathology, genetic studies, fineneedle aspiration (FNA), and referred laboratory services (with the exception of the basic Baby Screen)Rehabilitation services (i.e. physiotherapy, occupational and speech therapy); Homecare servicesAccident and emergency servicesDischarge (take-home) medicationsNon-medical items / services (e.g. lodger, minibar, extra meals, laundry, IDD calls, etc.)Pre-admission investigationsDoctors’ feesFor Caesarean Delivery (Elective or Emergency):Use of forceps or vacuum pumpUse of labour ward delivery facility, Entonox, CTG monitoring, and other items / services prior to Caesarean delivery (forvaginal-to-Caesarean conversions)WITHDRAWAL OF PACKAGE ARRANGEMENT:Parkway Hospitals Singapore Pte Ltd may, upon review of the specific case details by the Hospital CEO, withdraw the packagepricing arrangement and charge retail prices for the services and supplies consumed by the patient following the patient’sadmission in the event of any of the following:Additional procedures taking place within the same admission except for postpartum ligation; and / orHeavy usage or consumption of tests, supplies. medication, gases and / or other consumables during the packagelength of stay beyond normal bounds, whether arising from complications or otherwise.OTHER TERMS AND CONDITIONS:1. All package exclusions are charged at retail price. If used, they will be charged in addition to the package price.2. Should your general ward stay (single-bedded or 2-bedded) exceed the stipulated length of stay, all room rates and items /services charged on the exceeded day(s) will be charged at retail price.3. There will be no refund if (a) you stay for shorter than the specified package length of stay; or (b) your itemised bill upondischarge is less than the package price.4. In the event of a room upgrade to or downgrade from 1BD (i.e. private room), the 1BD package shall apply.5. Packages are applicable only if your doctor has selected one of the above packages and indicated it in your admissionletter.6. The package price is payable in full upon admission. All additional charges incurred whether from the use of excludeditems / services, exceeded stay or otherwise are payable upon discharge.7. Package prices do not include doctors’ professional fees, which are payable upon discharge.8. All payment is to be made via cash, credit card, or Medisave only.9. Parkway Hospitals Singapore Pte Ltd may vary the terms and conditions contained herein without prior notice.I, __________________________________, hereby acknowledge that I have received financial information on theabove package. I understand that the financial information that I have received only provides an estimate of the size ofthe hospital bill, and that this estimate shall not be construed to be a representation or guarantee of the cost of the finalbill.Acknowledged by : Date :Signature of Patient / Parent / GuardianWitnessed by : Date : ___________Name and Signature of Hospital StaffMEH-WC-10Created on 15 Sep 10Last amended on 15 Sep 10