Is Form C still in use?
Form B and Form C are financial counselling template forms previously developed by MOH for use by doctors, and Form A for hospitals. The forms have since been revised as follows:
Current | To be replaced by: |
|---|---|
Form A – Financial counselling form for hospital admission and day surgery | Medical Institution Fees Financial Counselling Form |
Form B – Financial counselling form for doctors not employed by hospital | Doctors Fees Financial Counselling Form |
Form C – Declaration form for doctors not employed by hospital if the doctor does not wish to disclose his fees to the hospital | Non-disclosure of Doctors Fees Declaration Form |
While it is not mandatory for providers to use these forms and they are able to design their own forms for the purpose of financial counselling, doctors may wish to share with the acute hospital or ambulatory surgical centre what they have counselled the patient so that they are better able to address queries on total charges from the patients. However, if the doctors do not wish to, they may use the "Non-disclosure of Doctors Fees Declaration Form”.
Nevertheless, we encourage Acute Hospitals or ASC licensees to check if financial counselling has been done by the Outpatient Medical Service licensee upon admission of the patient.
Related questions
If patients do not acknowledge financial counselling, what is the appropriate follow-up action ?
For the conduct of financial counselling where there is a change in the licensee’s fees for the treatment or procedure that the patient is undergoing, is there a guide to define fee changes or is there a range that we can work within?
Are Public Healthcare Institution licensees required to provide MOH fee benchmark when performing financial counselling?
Can licensees refer their patients to the relevant websites for fee-related information (e.g., MOH fee benchmarks, CPF MediSave and MediShield Life claims calculator to check on estimate claimable coverage) as part of the financial counselling?
