Letter to PM and CM-Grievance regarding billing for COVID-19 treatment of K Laxmi Narasamma in Telangana:N Sai Balaji

Dear Sir/Madam, 

Grievance regarding billing of patient Mrs. K Laxmi Narasamma (UMR20072800087) for COVID-19 treatment in violation of Telangana Government Order of 248 Dated 16th June 2020 

August 6, 2020


1. My aunt, Mrs. K Laxmi Narasamma (65 years old, UHID: 18082832) has been admitted in Mallareddy Narayan multi Speciality Hospital, Suraram, Hyderabad since 28th July 2020. She is currently admitted in COVID ICU -2. Through this letter I wish to register my grievance regarding the incorrect billing for my aunt COVID treatment in hospital, which is in violation of the Order issued by the Telangana Government on 16th June 2020 prescribing maximum per day package rates for COVID related treatments in private hospitals in Telangana. 

  

2. Through its GO No. 248 dated 16th June 2020, the Telanagana Government fixed the maximum rates, in an private hospital, for an admission in the ICU without need for ventilator care at Rs. 7,500 per day and for an admission in the ICU with ventilator care at Rs. 9,000 per day.  

  

3. Further, the Order directs that: 

  

2. “The rate included monitoring and investigating like CBC, urine routines, HIV spot, HCV, Hbs ag, Serum Creatinine, USG, 2D Echo X Ray, ECG, Drugs, Consultation, Bed charges,meals. Procedures like Rylestube insertion, urinary tract catheterisation”. 

  

3. Private hospitals display these rates at prominent places in their premises. It is the duty of the hospital to explain the patient/relatives about the charges for various services. 

 

4. Within these rates, the order didn’t specify any upper limit for PPE kits, other tests like MRI, CT scan, and other interventional procedures. However the present hospital is charging rs 12,000 per day for PPE kits, which is not only exorbitant but seems like extortion.    

  

4. At the time of my mother’s admission on 28th July, my family was not informed about the rates fixed for COVID-19 treatment by the Telangana Government. We were told that the hospital had a COVID-19 package for ICU admission i.e. rs 50,000 per day excluding ventilators charges. We were asked to immediately deposit Rs. 5 lakhs but because it was too large a sum, we could only deposit Rs. 4 lakhs.  

  

5. In the first few days of my mother’s admission in the ICU, she was receiving oxygen and non-invasive ventilator support. She has been on ventilator support since 5th July. We are not satisfied with reportsing regarding her treatment as its not being share with us by her doctors. It is only after repeated calls and requests, we were allowed for a twice a day video call with the patient. This didn’t include a phone call or virtual meeting with the doctor to understand what treatment they were giving. 

  

6. On 5th August, the billing section called my cousin to deposit one more lakh as the previous money has been exhausted. But no provisional bill was given until we had to fight for it. It was only after a argument that a provisional bill of Rs. 4,26,243 for 9 days of admission (28th July – 5th August July) which was a huge amount. 

  

 The breakdown of the provisional bill is as follows:  

 

ICU Isolation Bed Charges Rs 9000 per day 

Rs. 72,000 

Dr ER Physcian Rs 400 per day 

Rs. 2,800 

Dr Surapuraju Suresh rs 600 per day 

Rs 4,200 

Dr Nitya rs 600  per day 

Rs. 6,00 

Dietician Rs 75 per day 

Rs 575  

RFT test (4) per test rs 770 

Rs. 3080 

LFT rs 770 per test (2) 

Rs. 1540 

LDH 

Rs. 230 

GRBS blood sugar rs 80 per test (11) 

Rs 880 

ABG rs 1230 per test (2)               

Rs 2460 

ECG rs 230 

Rs 230 

COVID testing rtPCR  

Rs 2200 

CBC, CBP, PT/INR 

Rs 2200 

Ferritin 528 rs per test (2)  

Rs. 1056 

  

 

  

Pulse oximetry rs 390 per day 

Rs. 3120 

Oxygen Perday (Rs. 3080 per day) 

Rs. 24,640 

ICU isolation care charges per day rs 7000 

Rs 56,000 

PPE (Rs. 12,000 per day) 

Rs. 96,000 

Investigative Charges rs 2500 per day 

Rs. 20,000 

Medical Record Charges 

Rs. 390 

Doctor fees in isolation ward rs 8000 per day 

Rs. 64,000 

Administrative service charges for ICU isolation rs 1000 per day 

Rs. 8000 

Admission  

Rs 260 

Pharmacy chargers IP  

Rs. 59,012 

  

Total  Rs 4,26, 243  

  

7. During this time I came to know that the Telangana Government had capped the rates for COVID-19 treatment (specifically, Rs. 7,500-9,000 per day for ICU admission) and realised that the hospital charges were extremely high as compared to the government rates. In fact, the average charge per day was more than Rs. 60,000. My family was very concerned because we do not have the financial capability to cover such huge costs. 

  

8. Because of the efforts of a concerned family friend who tried to contact government authorities for clarification about the rates, I raised the issue on twitter tagging government officials. Srinivas Rao, DHMO contacted me on twitter saying action will be taken. However, I was not contacted, hence I found out his number and lodged a complaint through watsapp on 31st July and 4th August requesting to take action. Yet there has been no response.  

  

9. In spite of repeated requests and also informing the hospital about the government order, the billing section said the GO is not applicable to them. However the government order doesn’t give any exception. More surprising the hospital also included the costs that the Government of Telangana stipulated in its order in the provisional bill for example ICU Isolation bed charges rs 9000 per day includes ventilator charges also, however my aunt has not been administered with ventilator till now.  

Similarly other exorbitant prices have been mentioned. The copy of the provisional bill is attached with the mail.  

  

10. As you are aware, the Telangana Government rates are applicable in private hospitals on all COVID 

   

11. We are not even receiving regular updates about my aunt’s medical condition from her doctors and we are unable to even understand her situation and no consent is being taken from us about the treatment. My family is facing difficulties in undertaking the expenses according to the hospital’s rates and I am therefore requesting the billing to be as per the rates fixed by the government. 

  

I therefore request to take action against the hospital and demand the hospital to change  the billing for my Aunt's COVID treatment according to the maximum allowable per day rates laid out in the Telangana Government Order of 16 June 2020, and to also provide me with a corrected provisional bill. 

  

Looking forward to your positive response. 


Sincerely, 

N Sai Balaji 

Nephew of K Laxmi Narasamma,

8-4-371/8/93, Saradhi Coop Housing society,

Mothinagar

Hyderabad-500018


Note: This letter has been sent to the following addresses:


pmoffice@gov.in


dr.harshvardhan@sansad.nic.in 


pstohfm@gov.in 


secyhfw@nic.in 


cmo@telangana.gov.in


secy_cm@telangana.gov.in


prlsecy_hmfw@telangana.gov.in


rajbhavan-hyd@gov.in


dg_dca@telangana.gov.in 

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