What waiting time mediation can do for you
Imagine: you are referred to a hospital for an operation on your hip, but there turns out to be a 6-month waiting period. Of course you had hoped to be helped sooner, but what else can you do but quietly wait your turn? Engage your health insurer, because with their help the waiting time can often be shortened considerably.
Do you have an operation or other medical treatment ahead of you, but it is still far from your turn at your neighborhood hospital? Research by the Consumers’ Association shows that it is worthwhile to enlist the help of your health insurer in the event of a long waiting period. Everyone is entitled to waiting time mediation, because this service is part of the basic package.
In 2010, no fewer than 84,000 people contacted their insurer to be able to have an operation more quickly. In the end, about 38,000 people actually took advantage of this opportunity.
How does it work?
Whether it is possible to be helped earlier with a necessary treatment does not only depend on health insurer and hospital supply, but also on the patient. You are always the one who determines how far you want to go to have surgery earlier. For example, you must indicate how far you are willing to travel for treatment. Is that allowed, for example, abroad or in a private clinic? In addition, it is examined – together with the specialists – whether treatment in another hospital is even possible.
When the situation has been fully mapped out, the health insurer will call various hospitals to find out whether you can find an alternative to treatment in your ‘own’ hospital. They will pass this on to you, so that you can make an appointment for treatment yourself. This way you are in control of your treatment at all times. Some insurers already book a place, for example if a spot on the operating table has become available just before that week. This is of course always in consultation with you.
When mediation?
In principle, you can request mediation from the health insurer for all care for which you need a referral from your GP. Some health insurers also offer this mediation at, for example, physiotherapy, psychological help or dental treatments. You can find out whether this is the case in your case in the policy conditions of your (supplementary) insurance.
Preferential treatment
More than half (60 percent) of health insurers refer for specific procedures (if possible) to treatment centers with which a contract has been concluded for that specific procedure. The insurers make agreements with these centers about, for example, quality and waiting times. As a result, the waiting list is often shorter. If you do not want to accept the alternative of your health insurer, you are of course free to look for another practitioner or to wait for the treatment in the original hospital. Engaging the health insurer does not oblige you to anything.
Does it really matter?
Health insurers do not guarantee that it will be your turn earlier for every procedure. If you have a longer waiting period, it is worthwhile to contact the health insurer. The time saved in ophthalmology could increase to 3 months in 2010 and to 2.5 months for surgery.
Are there any drawbacks?
The use of waiting time reduction can be of great benefit. Keep the following caveats in mind:
• The travel distance can be much greater. You also have to go to the other hospital for the follow-up check-ups.
• The health insurer cannot shorten the waiting time in the original hospital. This is only possible if you need emergency treatment. This choice is made by the doctor, not the insurer. Health insurers only mediate to other health care providers.
• The entire treatment is taken over by the new care provider. So you actually start all over again. For example, it is not possible to be placed directly on the surgery list of the alternative care provider. First, a consultation with the new treating physician is required. Of course, the insurer tries to take into account the waiting time for the operation during the mediation. This often means that it is your turn sooner than if you had stayed with your old practitioner.
• There is a chance that the attending physician will propose a completely different treatment or even refuse you.
Your health insurer can use the information you provide to make a good estimate of whether it is wise to move to another hospital. So it is always wise to contact them when you are placed on a waiting list.
Top 5 waiting time mediation
• Orthopedics
• Radiology
• Neurology
• Surgery
• Ophthalmology
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