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25 Sep 20, 22 tweets, 24 min read
How can medical insurance companies NOT trick their customers!

Guidelines on handling of claims reported under Corona Virus: irdai.gov.in/ADMINCMS/cms/w…

(Images from thread below by @AnooBhu)

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Ashraya Hospital, Chikmagalur, Karnataka

Bill splitting:

Doctor's visit charges alone is ~₹2 lakhs.

Separate hefty charges for COVID ICU, oxygen, NIV, etc.

Hospital admit: 24.08.20, discharge: 11.09.20

@malini_aisola @RemaNagarajan @inayat_s_kakar

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Is @MaxHealthcare charging ₹ 8 lakhs when earlier estimated cost to the patient was ₹ 3.5 lakhs? What sort of inflation is this?

@malini_aisola @RemaNagarajan

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❗️Action against 27 TN pvt hospitals for overcharging: 1 hospital pulled up for discharging a patient at midnight for being unable to pay bill, some others had to make settlements of up to Rs 2 lakh after charging excess fees.



newindianexpress.com/states/tamil-n… Image
#COVID19 Pune: Measures to curtail overcharging ineffective.

The audit teams would only check bills of patients who've been charged more than ₹1.5 lakh, leaving majority of patients out of its purview. via @varshasuman

cc @malini_aisola @RemaNagarajan

thewire.in/health/covid-1…
Thread by @malini_aisola about billing of PPE & prices paid by patients for COVID treatment.

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Looks like weird refusal of mediclaim from @StarHealthIns.

Total bill is ₹ 6.41 lakh. Can one not use multiple insurance policies/claims to cover the bill?

@malini_aisola @RemaNagarajan @ramavenu @suchetadalal @MoneylifeIndia

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@MaxHealthcare profiteering from COVID19 patients.

Also note that Tocilizumab is still mentioned when there's no +ve evidence and only -ve results from RCTs so far. Also, check how exaggerated other charges are on daily basis.

@malini_aisola

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Moolchand Healthcare @Moolchand_Hosp w/ post-COVID19 packages. Doctor consultation also for "Ayurveda".

Where is line between evidence-based treatment & quackery? Are patients clarified on method of treatment & evidences behind?

@malini_aisola

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#MedicalHostage When patients or deceased are kept hostage by hospitals until bills are paid as per demand of hospital admins.

News story on issue covered by @SwetaDash93: thewire.in/health/private…

#HealthRacket

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1. Referral to fraudulent firm for loans by @MaxHealthcare staff and later not helping customer solve the issue arising due to it.

2. Overcharging of ambulance fees.

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Ex-servicepersons are also troubled by some ECHS Empanelled Hospitals. Some ECHS hospitals refuse to provide required medical attention which has also led to deaths.

@malini_aisola @RemaNagarajan @sanjg2k1 @drharshvardhan @MoHFW_INDIA @adgpi @PMOIndia
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Dhanwantri Nursing Home, MBD under Dr Ankit Verma took ₹137000 cash advance from patient. But doctor is refusing to give proper bill (w/ batch no.) for drugs on discharge. Patient's kin also concerned for genuineness of drugs prescribed/used. @ICMRDELHI
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Outright overcharging patient (e.g., multiple ICU charges for same day) by @NarayanaHealth.

Tocilizumab to 85 yr old lady w/ moderately severe or severe COVID19 seems medical negligence. There's only -ve evidences so far, see thread 👇.

@drlokeshksharma
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📢Cautionary notice for @Director_NABH accredited "allopathic" hospitals.

Some NABH accredited allopathic hospitals are employing AYUSH doctors for clinical duties @ ICU & other patient cares meant for MBBS RMOs & emergency doctors.

via @malini_aisola
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Patient age 62 yrs, admitted on 28 Oct '20 @HospitalsApollo, Belapur. For 40 days of COVID19 related treatment, bill of ₹ 22 lakhs bill on 8 Dec '20. Family was told that further 1 month needed for recovery as per hospital, w/ est cost of ₹ 50 lakhs.

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Star Hospital, Hyderabad charging COVID19 patient for over ₹ 1 lakh per day. Also possibility of polypharmacy (incl. plasma therapy). Medicines/consumable alone are over ₹4 lakhs.

Are state govts & central govt monitoring COVID19 treatment costs?
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Details described by @RakeshMithai show thuggery of Medicare Hospital, Nagpur. It's plain loot & lack of empathy towards patients. They not only denied medical bill, but also claimed/bargained unnecessary amount for treatment patient didn't avail.
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Farmers in Nashik being looted by some pvt hospitals: no billing, over charging, etc other than rude behavior towards patients & families. Also, Pvt hospitals seem to be taking benefit of lack of awareness about possible home care for mild COVID19.
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CHL Hospital, Indore is overcharging for COVID19 treatment, & threat of no medicine if no payment.

8 days in hospital.

Consultancy: ₹26800
PPE kit: ₹9000
Oxygen: ₹24000
Room: ₹45400 (incl. of single day ICU)
....
Total: ~₹3.2 lakhs+ Service: ₹30000
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Ashoka Medicover Hospital Nashik charged ₹ 7.4 lakh to @j_baviskar's father huge bill for COVID19 treatment (15 Feb 2021 to 1 March 2021).

(Price of Ulinafic Inj seem to be more than online sale price.)

(Did they inject 7 Remdesivir &1 Tocilizumab too?)
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More from @das_seed

सिद्धार्थ Profile picture
18 Mar
Pause of AZD1222 vaccine by some EU countries (Germany, Denmark, etc.) when UK has not raised any concerns, is relevant for India because > 85% of vaccine currently being admin in India is COVISHIELD (SII's AZD1222).

Thread on safety data from MHRA,UK

\1
Up to 28 Feb 2021:

1st doses of COVID19 vaccines administered by UK

- 10.7 million of BNT162b2

- 9.7 million of AZD1222

& ~ 0.8 million 2nd doses mostly of BNT162b2.

AEFIs reported via Yellow card:

- 94809 of BNT162b2

- 201622 of AZD1222

- 843 unspecified

\2 Image
Up to Feb 28, 2021 in UK:

~10.1 million received Pfizer/BioNTech's mRNA vaccine, whereas 9.7 million received AZ/Oxford vaccine

Deaths reported via Yellow card:

- 251* of BNT162b2

- 275* of AZD1222

- 6 unspecified

% of deaths in vaccine recipients: AZD1222 > BNT162b2

\3 ImageImageImage
Read 24 tweets
सिद्धार्थ Profile picture
13 Jul 20
Restricted Use of #Itolizumab for CRS in moderate to severe ARDS patients due to #COVID19. No peer-review.

❗️Phase III clinical trial exempted, to go for Phase IV.

Wordings of SEC meeting & Dr Sandeep Athalye, Chief Medical Officer, Biocon Biologics, have similar tone. 👇
To understand how HUGE scientific rationale can be, check her discussion w/ @SadhguruJV, a repeat offender. She speaks on DATA as well.

Both spewed lot of misinformation & judgement that could endanger public health & lives.

How are major arguments used by @kiranshaw here not different than arguments made by @yogrishiramdev on #CORONIL? Both playing on emotions like "made in India", "used since ages", "rigorous clinical trials not so relevant in pandemic". @CDSCO_INDIA_INF

Read 31 tweets
सिद्धार्थ Profile picture
10 Jul 20
🚩What is community transmission? Is India under community transmission?
⚠️What are implications of community transmission? Why is @MoHFW_INDIA denying it?
🧐What are possible consequences if there's declaration of community transmission? How will it help public? (thread)\1
@WHO's definition of community transmission allows govts to announce/deny community transmission based on their agenda. Maybe vague but @MoHFW_INDIA is NOT in position to defend its denial. "COMMUNITY TRANSMISSION" is officially used in @MoHFW_INDIA's critical policy/rules. \2
March 23 by 1800 IST, 2020, we officially had 433 COVID-19 cases, 7 deaths, 402 active. @PMOIndia declares nationwide strict lockdown for ~2 months. Only few places officially had local transmission on. Today, 25 states/UTs have 500+ active cases each. \3
Read 15 tweets
सिद्धार्थ Profile picture
6 Jul 20
🚩Unprecedented time demands pertinent questions.

IMO, we are often not asking questions appropriate to priority.

e.g.,

1. Ask about quality, quantity, delivery status of medical devices (PPE, N95 masks, ventilators, sanitizers, etc.). NOT price even if its via #PMCARES. \1
Lives are getting lost due to delay, low quality, shortage while disease keeps spreading. You need to save healthcare workers else who will take care of patients even if we keep adding beds.

Money NOT an issue, have $2250 million loan from World Bank+ AIIB alone for COVID18.\2
Need obsession w/ saving lives & economy of country. We can ask about #PMCARES even later, but can lives lost due to shortage/quality/delay be brought back? No. Your question should determine your priority goal.

❗️allocation ≠ transaction.

Need patience for balance-check.\3
Read 5 tweets
सिद्धार्थ Profile picture
29 Jun 20
📋CLINICAL MANAGEMENT PROTOCOL: COVID-19 by GoI, @MoHFW_INDIA provides guidance to #COVID19 medicare and mgmt units all over India.

❗️Essential to be FACT-based, well-INFORMED, UPDATED.

⚠️Sadly, its not well-informed or fact-based. Needs URGENT UPDATE/REVISION now. e.g., 👇 Image
❗️Some MISINFORMATION based on outdated @WHO's surveillance guidelines & info (~March '20).

❗️Ignored information post mid-March from EU, USA, India though these form major % of total cases.

❗️ECOLOGICAL FALLACY.

❗️Systematic CALLOUSNESS.
\2 Image
❗️SARS-CoV-2 transmitted from HUMAN-to-HUMAN by infectious droplets, arguably AIRBORNE & ocular mucosa (may also be Faecal-oral).

❗️Asymptomatic: Infected but will never show symptoms.
Pre-symptomatic: Infected & will show symptoms eventually.👇 \3 ImageImageImageImage
Read 14 tweets
सिद्धार्थ Profile picture
4 Jun 20
⚠️Public health @ risk: Misinformation by @PMOIndia @NITIAayog @ICMRDELHI

❗️COMMUNITY TRANSMISSION on.
❗️UTTERLY LIMITED test capacity & medical facility.
❗️NO ESTIMATE FOR % ASYMPTOMATIC, not in India and not for global popn!
❗️still EARLY stage. \1
❗️PRE-SYMPTOMATIC ≠ ASYMPTOMATIC.
❗️Pre-symptomatic can be EXTREMELY contagious as symptomatic ones.
❗️ECOLOGICAL FALLACY is BLUNDER.
❗️Self-ISOLATION/QUARANTINE when suspicious of exposure to infection is MUST. \2
❗️AVERAGE w/o RANGE, CONFIDENCE INTERVAL (where relevant), and SAMPLE SIZE holds too little or NO meaning.
❗️There're LIMITS to STATISTICAL INFERENCE, which SHOULDN'T be ignored.
❗️FORGED data yields USELESS calculation w/ NO valuable inferences even if plots look PRETTY. \3
Read 4 tweets

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