Only 3 visits to doctor allowed monthly for a single diagnosis — new NHI policy
The National Health Insurance (NHI) has implemented a new policy that limits the number of times its beneficiaries can make visits to medical practitioners per month.
A media release from the NHI this week said beneficiaries will now be allowed one primary visit and a maximum of two follow-up visits for a specific diagnosis within a thirty-day timeframe.
“If further visits are required for the same diagnosis, NHI must be notified in this regard and additional visits may be granted on a case-by-case basis. NHI reserves the right to recommend a second opinion or referral to a specialist for the beneficiary if deemed necessary or if one was not previously sought by the practitioner providing service,” Manager of Beneficiary and Advisory Services, Casandra Lewis explained.
She added: “The goal of the policy change is to ensure all beneficiaries receive quality care with a view to improved healthcare services throughout the Virgin Islands, along with adequate fiscal responsibility of the NHI fund.”
Meanwhile, Medical Director Dr Harlan Vanterpool alluded to past cases to further explain why this new measure is necessary.
“In some cases reviewed by NHI, it has been found that some providers have not been through enough in their medical assessments of beneficiaries, resulting in the misdiagnosis of beneficiaries, and by extension, the commencement of treatments deemed inappropriate. In some of these cases the needed specialist input was not sought in a timely manner,” Dr Vanterpool said.
He further said: “This has resulted in patients seeing the same physician repeatedly, continuing with the same treatment, and not seeing any improvement in their condition. Again, in these cases, beneficiaries are not receiving appropriate care, which may result in their conditions worsening or they may also develop other issues associated with being administered inappropriate treatments.”
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“along with adequate fiscal responsibility of the NHI fund.”
Where was this fiscal responsibility when the local health care providers outrageously drove up the cost of their services once N.H.I. came on stream and nothing was done about it?
Rationed healthcare. Just like in the UK. And we are still paying ridiculous prices!
Much of the increase cost was created by NIH because they fail to consult with experts in the field and went ahead and set prices way above average market pricing so now all practitioners are charging the maximum NIH allows which is way above their customary fees.
This is what happens when you grant unlimited Government funding for medical procedures, but you fail to take any steps to negotiate or control prices.
I could see why the old NDP Government never did this (because of all the family ties to the medical industry). But there is no excuse for the new VIP Government not taking steps to resolve this.
Let me be the first to say that this is absolute and undeniable BS.
BUT HOW???? This is ridiculous!!!! What if we have a serious health concern for that short particular season? What about the several months of no doctor visit at all but consistent payments made into the system. So unfair!!!!
Did you guys even read the d**n article? It said in ONE MONTH, not ONE YEAR. It also says special requests would be granted by NHI. We cannot continue to rape the Government programs and still want them to function properly.
At the end of the day it could have been 3 times per week. YOU CAN NOT PUT A LIMIT ON HOW MANY TIMES A PERSON NEEDS TO SEE A DOCTOR. We are paying for it so if we need to go everyday then SO BE IT!!!! GTFOH! That is the mentality that is causing the country to suffer more than we already are.
If your fit enough to visit the doctor every day then you don’t need to go to the doctor…..simple
Special requests MAY not would be granted.,,,please read. It is not for certain
Did NHI tell the doctors? They are the ones who set the appointments not the patient.
My name is Sam am St Lucian by birth, I have been diagnosed with a chronic illness. I am paying my NHI as required and really ill at this time. The doctor sent all the info to NHI over 8 months now so I may be assisted in a surgical operation. NHI didn’t even contacted me, I personally went to inquire but with no help. I am young and may not be no more but the admin within the NHI God will deal with them one day. I know others with the same illness BVIslands to be precise and was address promptly…
Very sorry to hear this. Can you ask to speak with someone senior at NHI, not just the person at the front desk or at reception but a manager? They may be able to help.
Other than that you can ask your boss or your pastor or someone in the community to speak to them on your behalf.
This is long overdue. These doctors are crazy!
This is utter nonsense. You mean to tell me, y’all are deducting money from my pay check to go towards NHI then telling me how many times I can use it????? FOOLISHNESS. Y’all better wheel and come again! What needs to be done is regulating these health care facilities from having them RAPE the damn system!!!!!!!!
Get rid of socialized healthcare. It’s unethical. Let us choice our own health care plans. And pay for them ourselves.
We had that already, and so many people had no insurance and people were expecting government to find the funds to fly them out if need be.
It is the health service providers needing regularisation. Their costs are way out of the charts since the NHI introduction.
Omg. Help us lord. This is crazy. How can you control sickness? If you sick you sick so therefore you have to visit the doctor. All tht money you paying over cover 3 visit. Crazy place.
They don’t care. Why can’t we have insurers compete for our business? And that would also bring more jobs.
Many of us had our health insurance for years with no problems. Because of the mandatory NHI, we could not afford to pay for the 2 so had to drop our insurance coverage. Now, for example, a person feel a pain in their side, go to the doctor and was given a pain killer, pain not subsiding and return for the same thing, doctor say its gas, give you dica and send you home. No relief and pain gets worse, and you return to doctor (might be a new doctor or even emergency room for same pain) they give you an injection, run a test, say it doesn’t seem to be anything and send you home. Middle of night you call ambulance, and now they know its a ruptured appendix or something, surgery and hospitalization but no coverage. How fair can than be to an sick person?
Please read and understand. How many times are we normally asked to return for a follow up? Not many. And at least for me once I start to feel better I don’t usually go back. They did say they will evaluate each case on its own merit. Some doctors usually say come back in 2 weeks but that is just for safety reasons. Why you going back if you’re feeling better?
Bottom line we are paying for everyone else’s healthcare. Rather than our own. What’s next we have to pay to feed everyone. Socialism doesn’t work!
If y’all are gonna keep taking money out my pay check, I need to be able to be up in that doctor’s office everyday if I need to be.
There seems to be a problem with reading and understanding what is read. In my interpretation, the article is simply saying that for each diagnosis, three visits (including follow-up visit) will be allowed during a 30-day period (and of course, the period may be longer at times). In these cases, NHI said they can be notified, and further visits can be granted and/or recommendations for referral to a diff. physician (if warranted as necessary).
Amount of times for visits should be between doc and patient. Government should not be in your personal healthcare. This is the beginning of rationed care.
So NHI trying to tell grown people when they can go to the doctor and which doctor they should see within a mmo…what kind of bafoonery is this!
This is not a school where a field trip paper is to be signed off on!
There is no issue with reading or understanding….People are just facing the reality. What we are saying….If someone paying into a system on a monthly basis for their health care…lets say for 2 years straight and had no reason for a doctor visit…all of a sudden a serious condition or emergency shows up or occur. And now we will be limited. Its not right. When they say after the 3rd visit they will evaluate. That’s mean it have to go through a process to be approve and that takes time…What if its an emergency situation and they have you hold up. READER…you are the one that don’t understand when those sticky situation pops.
People this implementation is for your good. Did you all take the time to read the paragraphs below?
Meanwhile, Medical Director Dr Harlan Vanterpool said research has shown that these new measures are necessary if the health care system in the BVI is to improve and become stronger.
“In some cases reviewed by NHI, it has been found that some providers have not been through enough in their medical assessments of beneficiaries, resulting in the misdiagnosis of beneficiaries, and by extension, the commencement of treatments deemed inappropriate. In some of these cases the needed specialist input was not sought in a timely manner,” Dr Vanterpool said.
He further said: “This has resulted in patients seeing the same physician repeatedly, continuing with the same treatment, and not seeing any improvement in their condition. Again, in these cases, beneficiaries are not receiving appropriate care, which may result in their conditions worsening or they may also develop other issues associated with being administered inappropriate treatments.”
Did Dr. Vanterpool tell you about the 62 day wait to receive cancer treaym2 in the UK? That’s what I guess the Dr means by getting stronger?
So the people are guinea pigs to see if the system can improve??? Is this a game of Russian roulette
Where are the persons who spoke so bad about the belongers fast track system that our Primer proposed? They only have strength for expats
I agree with majority of the comments, this is complete BS and no different from the health care facilities raping, and I repeat raping the NHI system. NHI wants to now tell us how many times we can seek medical attention and where we can seek quality healthcare. Premier, this is your time to step in to resolve this nonsense. I want my private insurance back; they didn’t dictate where and how many times I seek medical attention. Damn forward institution!!!!
Utter BS!!! Come again!!!
So the doctors are getting it wrong, and that means the patients should be restricted in their ability to seek further help? This makes no sense.
Pure BS. NDP impose this BS on people.
Just another piggy bank to raid.
This is the tip of the iceberg. We fixed a problem for a few with a sweeping change that in my opinion is not sustainable because of the population size. People are living longer, have more chronic medical issues means things is only going to get worst. Only a few years and we are rationing health care.
Can you people be more stupid???? They are not saying you cnt go to the doctor after 3 times. They are saying nhi will intervene if th visits to the doctors or more than 3 times for the same diagnosis with no improvement. They will refer the beneficiary or patient to another doctor or specialist.
S o you trust government to make your healthcare decisions? Not I
We don’t need intervention. For what we’re paying we want freedom.
“If further visits are required for the same diagnosis, NHI MUST BE notified in this regard and additional visits MAY BE GRANTED on a CASE-BY-CASE basis.
NHI RESERVES THE RIGHT to recommend a second opinion OR referral to a specialist for the beneficiary if deemed necessary or if one was not previously sought by the practitioner providing service,” Manager of Beneficiary and Advisory Services, Casandra Lewis explained.”
THAT FIRST PARAGRAPH SAYS MORE THAN ENOUGH…THIS IS LUDICROUS!
However, with that freedom for you and i comes unscruperlous, dishonest thievery by dishonset professionals.
Eventually, the system that was painstakingly organize to help the sick and needy is being ravaged by greedy, blood sucking, conscienscienless vampires, will fail.
Unless, of course, stringent oversights can be implemented in that area.
It’s obvious that people do not understand what they are reading. It’s so sad, so so sad!
The English language is a special thing and the humans pretending to know it are a spectacle to behold…but then again when people only see things in dollars and cents its hard for them to see when something goes toward their quality of life…
If I going to a doctor all the time and all NHI seeing in the claim system is “complained of pain in toenail, prescribed paracetamol” for a continuous period every two weeks, I for one would be glad someone care enough to say ‘hold up, maybe its not her toenail, but maybe this doctor does not have enough insight to see past the toenail pain’ and therefore refer me to someone who might be able to take me past paracetamol prescriptions…
No where did the thing say you will be stopped from going to the doctor if you need to see the doctor.
“A media release from the NHI this week said beneficiaries will now be allowed ONE primary visit and a MAXIMUM of TWO follow-up visits for a specific diagnosis within a thirty-day timeframe.
“If further visits are required for the same diagnosis, NHI must be notified in this regard and additional visits MAY(NOT GUARANTEED) be granted on a case-by-case basis.”
Looks like you need to hit the books.
Then they need to not take out monies from my salary for NHi that often.
Well NHI. Let the Doctors get it right and no one will return. I heard people return in 24 hours for the same condition that worsens. NHI already not paying for most things or there is a limitation on treatment.
May God help us.
NHI is failing and has not yet seen a profit nor will it ever see a profit at the rate it is going and using the current format. I’m seeing a lot of people saying that “we are paying for it so why are they trying to limit us” Most people are not paying enough to cover the expenses that government is incurring. It is a win for the consumers but a major loss for the government.
Some people are paying less than a $100 a month but one bill that government has to pay is almost 4 times that amount. The lowest paid employees still receive the same healthcare at the same cost as the highest paid employees. Someone on a lower income scale is paying $36 monthly but in one visit to the doctor government can easily pay more than what they contribute in a year. Doctor visits are also on the rise as some people that rarely visited the hospital are now going more often since they are forced to pay for NHI. Every death, every birth, every incarceration, every person that turns 65 years and older results in more losses for NHI each year. Also Police, Fire, Immigration and Customs officer and the mentally challenged do not contribute.
Since NHI was implemented it seems like some private Medical centers increased their fees.
If NHI does not turn a profit within their first 5 years they will need to shut it down or revamp their policies.
In 2017 the total expenditure for NHI was $80,476,662 while they only had a total income of $79,882,819 which led to a loss of $646,843. They also reported that they were expecting bigger losses in 2018.
If NHI was a private company they would have stopped doing business months ago.
Of course the Government will be at a loss. It has NOTHING to do with what people are paying into it but EVERYTHING to do with how much the health care facilities are charging. $172 for a frigging doctor’s visit for 10 minutes. ABSURD!!! The Government MUST be at a loss if they RAPING the damn system. So what you saying makes no damn sense about the bill the patients are racking up versus putting to the scheme
Andrew going make this island a living. Unbearable ..
And just now they gonna raise the price againn..smh… killing us mannnn..
I do not understand what people are complaining about. A lot of people including employers are not contributing to NHI. As stated previously the amount some people are contributing per month is less than $100.00 and still expect to go Doctor hunting. Along with that persons who are not contributing want to use the most expensive medical center. How do you expect NHI to function if they do not use limits. I beg you to name a health insurance that do not have limits here in the BVI or oversees.
Anyone send them to implement this mandatory NHI
all the private practioners are ripping off the NHI. its a very useful thing the govt did for the people but the greedy private doctors and hospital just dont care they raised their fees 100% more. The owners of those private places have no compassionate at all.
Is it normal or ethical to limit a person to three doctor visits per month? I have never heard of this practice, and those of us with other insurance policies are not restricted in this way. I am baffled by this new restriction.
With NHI 3 visits per month equals to about 36 consultation per year. some insurance companies limit your consultation to 15-20 per year. They also limit depending on your plan consultation cost of $1,500.per policy year or $2,500.oo per policy year . If consultation is about $150.00 per visit and 36 visits per year that is $5’400.00 per year NHI will pay 90% of or 80% depending on whether the visit is local or oversees much more than what other insurance companies pay. I dont under stand the noise. All insurance companies have more restrictions compare to NHI. Consultation costs may be even higher than stated above.
Can I opt out of N.H.I? I pay in excess of 500 every month in addition to another medical insurance I have, and do not use N.H.I locally or abroad. I only pay because it is the law, but feel it is unnecessary to have. I prefer to choose my practitioner if a medical emergency should arise and have I to go off island.
No you can not because It’s mandatory
It is a shame! NHI hasn’t even proven itself yet and is running at a loss because of some greedy doctors who are going to bankrupt the system. In the US is medicare and a lot of greedy health personnel always end up in jail for ripping off the system and the same thing will happen here if we are not careful. In the next couple of years this place will be the most expensive place in the Caribbean. On another subject R*****y is selling a $6.00 lime/citrus squeezer for $18 plus dollars and people buying it like if they don’t have no sense.
NHI is a milking cow…..MILK MILK MILK MILK MILK MILK MILK HAHAHAHA
Owner of a large private clinic / center coming to hospital regularly looking for patients to bring to his center and milk the patient and NHI more.