There is a charge for asking for medical records, 4 cents to 1 yuan for a piece of paper.
Patients questioned the unreasonable charges and the hospital's desire to make money from it
I really didn't expect that the charge for medical records and medical records in hospitals could cause huge controversy in recent years.
On June 15, a netizen in Toutiao posted in an article: "Why do hospitals charge medical record printing fees? Some hospitals charge 4 cents a piece, some charge 8 cents a piece, and there are dozens or hundreds of yuan for a large number of cases, is this charge reasonable? Does anyone know? ”
Subsequently, the topic of hospital medical record charging immediately aroused heated discussions.
On June 16, also in Toutiao, a patient in Shandong complained about the same charges.
He said: "Recently, my mother was discharged from the hospital, and the reimbursement of NCMS and commercial medical insurance must be certified by the medical records provided by the hospital, and they must be stamped, otherwise they will not be reported." Then I went to the local hospital and asked the staff for medical records. The medical records are very thick, and the staff actually asked me for money after handing them over?! I asked him how much he was going to charge, and he said how many pages he counted, 8 cents a piece of paper! I was so angry that I wanted to spit out the fragrance, this medical record is so thick, at least 100 yuan, you open your mouth and ask me for money, and the huge medical expenses I paid at the beginning were paid in vain? Isn't the medical record fee included in the medical bill? According to my understanding, printing medical records is also part of the whole medical treatment, and the extra charge is simply unreasonable and unreasonable! Now as long as the reimbursement has to need this medical record, as long as the patient prints it, you have to collect money, do the hospital still want to rely on this to make money in the future? ”
The money for printing medical records is not included in the medical fee, and additional money is charged, which immediately caused controversy among people from all walks of life after this topic became popular.
Let's confirm first, do hospitals charge money for printing medical records for patients now? The answer is yes, money is generally charged, so why charge? Is the extra charge reasonable?
A doctor in Heilongjiang said: "I'm a doctor, let me talk about it, in fact, I didn't need money, but as a result, a lot of people made copies, and they could only charge to control the cost." If you are a commercial insurance reimbursement need, usually only need the home page, admission records, discharge summary, diagnosis certificate, national medical insurance settlement form, just a few pieces of paper, not a few dollars at all, originally did not intend to charge, as a result, most people come up regardless of 3721 is to copy the entire medical record, can not be persuaded, patients ask to copy medical records is a legal right, we have no reason to refuse, but the cost has to be paid by you, so it will be charged. ”
An emergency doctor in Anhui Province said: "Originally, I didn't need money to print, but the consequence of not wanting money is that everyone who came to print "Dream of Red Mansions" has it. In the hospital, many things were originally free of money, and the use of wheelchairs was originally free of money, but when the wheelchairs were used up, they were never pushed back to their original places, scattered in all corners of the hospital, and even pushed home. Originally, there was no charge for parking in the hospital, but then a bunch of zombie cars were parked in the hospital. ”
For the above cognition and opinions, a physics teacher in a middle school in Sichuan gave a rebuttal, he said: "Originally, I didn't charge money for printing, but now I collect money, why didn't I collect it before, but now I want to collect it?" Many doctors don't give a reasonable explanation. The most talked about is that the hospital collects money to prevent patients from taking advantage, okay, so you can limit each person to only one book, or limit the number of pages, why charge money? ”
"Now as long as the medical records are printed, they will charge extra money, in fact, this is not very reasonable, patients ask for medical records is a part of the diagnosis and treatment, it stands to reason that this copy fee is included in the overall expenses, is the hospital should be free of charge of medical information. The patient was hospitalized for more than ten days, and after being cured, should he be allowed to go back empty-handed? It is necessary to give a proof and summary of the hospitalization experience, which is the medical record, and this thing cannot be charged extra. ”
"For example, if a patient pays his daily hospitalization fee, he or she cannot pay the electricity and water bills in the ward. Once the patient has paid for the care, the cost of injections and dressing changes cannot be paid again. Similarly, if a patient pays a registration fee when he is hospitalized, he or she should get a free medical record when he is discharged. If the patient also wants a second medical record, then the additional charge for paper ink at this time can be understood. ”
The regulations stipulate that the hospital can charge for the printing of medical records
Patients: Poor experience after being charged
Can the first one be free, and the second one will be charged?
The debate is fierce, about whether there is a charge for the printing of medical records, and what are the relevant regulations?
According to Article 23 of the Regulations on the Management of Medical Records of Medical Institutions (2013 Edition), medical institutions may charge the cost of production in accordance with the provisions for reproducing medical records; Article 16 of the 2018 Regulations on the Prevention and Handling of Medical Disputes stipulates that if a patient requests a copy of medical records, the medical institution shall provide a copy service and affix a certification mark to the copied medical records. When reproducing medical records, the patient or his close relatives should be present. At the request of patients, medical establishments may charge a fee for reproducing medical records for patients, and the fee standards shall be made public.
Since the above two regulations indicate that fees can be charged, how is the fee standard determined?
Unfortunately, there is no universal standard. Due to the different economic levels of each region, some hospitals are self-exerted if they charge fees. For example, some hospitals in Anhui may charge 4 cents or 5 cents per page, and some hospitals in Beijing may charge 1 yuan per page.
Of course, individual provinces also have charging standards for medical record copying, such as the regulations of the Development and Reform Commission of a southern province: medical institutions copy medical records for patients, and their production cost standards are in principle implemented according to the market copy fee price. The specific standards are: 0.8 yuan/sheet for A3 paper, 0.4 yuan/sheet for A4 paper, 0.6 yuan/sheet for B4 paper, and 0.3 yuan/sheet for B5 paper.
Regarding the above regulations on the charging of medical records, Weibo self-media blogger "Cheng Cheng" believes that it is extremely unreasonable.
She believes: "Whether or not to charge for the printing of this medical record is vague in itself, and it depends on how the hospital does it." Hospitals print out medical records to patients, which is a basic health service, and it is not moral to charge extra fees. It's like if you go to a restaurant to eat, and you have to wipe your mouth with a napkin after eating, and the boss says you have to pay extra for the napkin, otherwise you can't use it! There may be nothing wrong with that, after all, we only paid for the meals, not for the napkins. But think about this move is particularly disgusting, go to the restaurant to eat, from entering to wiping your mouth out is a complete process, the restaurant provides napkins are included in it, and the extra charge will only make people feel the restaurant's undignified and narrow heart, the experience is very bad, and the hospital charges a medical record printing fee, the same is true! ”
In fact, not all hospitals charge an additional fee for printing medical records. Some netizens reported that he went to Tongji Hospital somewhere to see a doctor, whether it was an inpatient or an outpatient, the first medical record can be printed on the self-service machine, which is free, if you need more copies, then you have to pay for a copy in the medical record room. In the past year, he has been hospitalized frequently, and he found that the first medical record of his local central hospital and Tongji Hospital was free of charge, and this medical experience made him very happy.
It's not just a medical record fee
Film charges have also been questioned as unreasonable
In addition to the questioning of the fee for medical record printing, the previous charge for film when patients did magnetic resonance was also complained and questioned.
At the beginning of last year, a netizen in Tangshan posted a complaint saying that when he went to the hospital for an MRI examination, he was asked if he wanted film, and the film needed to be charged extra.
The netizen angrily sprayed: "I just don't understand, doesn't the examination fee of more than 480 yuan include the film money for seeing the results after the MRI examination?" Do I need to pay any more? Is this how all hospitals charge for film? It's so unscrupulous! ”
After the incident fermented, many netizens thought that the additional charge for film was "indiscriminate charging under the name of a clever name", "hollowing out more money to generate income" and "hooliganism".
At present, there are different practices in different places regarding whether to charge extra for film.
For example, Hunan Province stipulates that the examination fee for CT and MRI includes the film fee, and there is no additional charge; Some provinces and cities in East China require that after the patient undergoes MRI or CT examination, if he or she wants to bring the imaging data to be discharged for consultation or keep it for backup, there are two kinds of imaging data to choose from: one is film, which is charged by medical institutions at 20 yuan per sheet; The second is paper printed images, etc., which are provided free of charge by medical institutions. Medical establishments shall provide imaging materials in accordance with the patient's independent choice, and have the patient sign for confirmation.
A hospital in Shanghai clearly stipulates that if you need to print film, please go to the magnetic resonance registration office to handle it, and charge separately according to the Shanghai price and fee regulations.
With the development of electronic informatization, film has become farther and farther away from us. In the past, the imaging examination report would issue a film for clinicians to inspect, especially the doctors of orthopedics and respiratory departments, who would be given a light box to look at the film, insert the film upward, and card it on the special light box to check the shadow part of the film, so that the condition can be understood. Later, technology developed, doctors could view images on their computers, and patients could view images from all angles on their phones, and film played a smaller and smaller role.
What is certain is that in the early days there was a fee for film, but later the price department forcibly abolished the additional charge for film, and the cost of film was included in the inspection, and the inspection fee was set by the price department. Film is no longer charged extra, it is equivalent to the hospital to bear, each printed film hospital has to bear this part of the cost of additional costs, for patients, it is equivalent to reducing part of the burden, this is the price department to make a policy to benefit the people.
Later, film became less important and dispensable, and the price departments of some provinces and cities canceled this policy of benefiting the people. Now, the image data can be directly transmitted to the mobile phone, and the patient does not want film, of course, he will not charge money, but if he still wants to get the film as before, it is not so easy, because the policy of benefiting the people to receive the film for free is no longer there. For example, Shanghai has experienced three stages: film charging, film free, and film charging again, which is also the embodiment of the so-called "policy of benefiting the people to be used on the cutting edge".
According to the existing regulations, if the patient insists on the film, the hospital is reasonable to ask for the film fee, because at this stage, the hospital has no obligation to give the patient film, and the development of technology has put the film to the point of marginalization.
The full text is transferred from: Metz Medicine