Outpatient Medical Plan - Pros & Cons of Panel & Outsource
Panel Clinics Appointed by the Company
Pros:
1. Medical Certificate and medical expenses could be controlled.
Cons:
1. Administration Works
If a company appoints panel clinics for its outpatient medical plan, administration works start from identifying and appointing panel clinics. The company (usually Human Resource Department) will need to make sure panel clinics are available, at least within a certain radius of distance, for all employees. This would be problems for big organisation (>500 employees).
If the company appoints many panel clinics, there will be a lot of paper work of administering invoices from panel clinics.
2. Controls
Panel clinics might take advantage from the company, by charging high charges, due to the personnel in-charge of the company might lack of knowledge in medical matters. Also, staff might take advantage as well by incurring some medical costs which they are not supposed to claim (differ according to companies’ policy).
Outsource of Outpatient Medical Plan
Outsource of Outpatient Medical Plan means to appoint a company (in Malaysia, usually an insurance company) to handle all outpatient medical related matters.
Pros:
1. Lack administration work for the company, in appointing panel clinics and handling billings.
2. Number of medical certificates issued by every clinics is monitored by the outsource company, and investigation will be carried out if necessary.
3. The outsource company will check every claims made by the panel clinics. This will be done by the panel medical practitioners who have medical knowledge.
Cons:
1. The panel clinics might be “instructed” / tend to give lower quality medicine, as cost control imposed by the outsource company.
2. The premium paid might be high, as compared to the actual expenses incurred, as the premium of the current year will usually based on the previous year’s actual medical expenses incurred, plus the percentage of inflation rate of the current year. Technorati Profile
