Insurer pauses pre-authorisation for Mount Elizabeth hospitals

Great Eastern says high costs at two facilities the reason for the decision

- Judith Tan

Insurance group Great Eastern (GE) has temporarily stopped issuing pre-authorisation certificates for policyholders admitted to Mount Elizabeth hospitals from June 17.

The insurer said in a message to its panel doctors that high costs from both Mount Elizabeth and Mount Elizabeth Novena hospitals, compared to other private hospitals, were the reason for this decision.

Pre-authorisation confirms that the insurer has approved the medical treatment, including the costs, before the treatment begins.

It may cover the cost of the procedure, medications, and other related expenses. Patients who are policyholders have a clear understanding of the costs that will be covered, reducing the risk of unexpected medical bills.

GE told doctors its decision was not a reflection of their clinical quality, but the insurer was "prioritising facilities that deliver the same high-quality care with greater cost transparency and cost-effectiveness".

It said its policyholders can still seek care from the two hospitals with no change to their benefits and claims, and that claims would be processed according to the usual procedures.

In response to queries from The Straits Times, a spokesman for GE said: "Since pre-authorisation certificates confirm coverage and guarantee the claims before admission, we are temporarily pausing these for the specified hospitals, as this helps us address the issue of rising charges from the two hospitals."

The Mount Elizabeth hospitals are owned by IHH Healthcare, the largest private healthcare provider in Singapore, with four acute hospitals.

Its other two hospitals—Gleneagles and Parkway East—are not affected by GE's suspension of pre-authorisation.