KUALA LUMPUR, June 24 — Doctors at government hospitals should automatically offer mySalam to patients, with hospital registration staff helping submit patients’ claims for the health protection scheme, doctors said.
Doctors say the onus should be on the Ministry of Health (MOH), university, and army hospitals to push the application process for mySalam — which is run by the Ministry of Finance (MOF) — rather than to expect the poorest Malaysians to download a “Doctor’s Statement” form from the mySalam portal, print it out, ask their doctor to fill out the form, scan the form, and upload it to submit a claim online.
Former Malaysian Medical Association (MMA) president Dr Milton Lum questioned why the uptake and approval rates for mySalam were very poor, after CodeBlue reported that only 31 out of 737 claims for the RM8,000 critical illness lump sum benefit were approved from March to early June, equating to 4 per cent approval.
“Is there coordination between MOF and MOH and MOE hospitals? Are the agencies operating in silos?” Dr Lum told CodeBlue.
The Ministry of Education (MOE) runs university hospitals, which are also covered under mySalam besides MOH and army hospitals.
Dr Lum said he expected doctors at government hospitals to tell patients from the bottom 40 per cent (B40) that they may be eligible for mySalam, instruct them to fill out claim submission forms within the facility, and pass the forms to the registration clerk in the hospital, who should then scan the documents and upload them to mySalam’s office.
“Processes for B40 have to be one stop,” he said. “Don’t ask them to go here and there.”
“Processes for doctors have to be simplified with forms easily available and not requiring them to carry out numerous investigations to determine patients’ qualification.”
Although mySalam’s website FAQ states that claimants must download a “Doctor’s Statement” form, get their doctor to complete it, and upload it together with a copy of their identity card (IC) for an online claim submission, two representatives who answered mySalam’s hotline yesterday gave different requirements.
One told CodeBlue that a claimant must upload three documents: A “Doctor’s Statement” form and medical report from their doctor, together with a copy of the claimant’s IC; while another said only a medical report and copy of one’s IC are required, without needing to download any form.
Both mySalam call centre staff said claims cannot be submitted offline, when asked if application forms were available in hospitals. One of them said pictures of the “Doctor’s Statement” form and medical report are allowed to be uploaded, but the images must be absolutely clear or risk rejection even if just one word can’t be read. Claimants can also upload a picture of their IC, but the front and back must be on the same page.
Dr Lum also urged MOF to actively involve MOH in defining the criteria for coverage of 36 critical illnesses under mySalam that is administered by Great Eastern Takaful Bhd, which he said should be made clearer and less stringent. mySalam does not cover pre-existing conditions diagnosed before January 1 this year.
“Input from attending doctors and hospital administrators on the awareness and processes would improve the uptake,” he said.
“At this rate, there will be many unhappy B40 patients with political ramifications. Had the policymakers and administrators sought professional input and more importantly, listened before rushing to implement, this sad state of affairs may not have happened or at least been mitigated.”
According to MOF, 2,474 people have applied for mySalam from March to early June. A total of RM349,600 has been disbursed to successful applicants, comprising RM248,000 for 31 critical illness claimants and RM101,600 for individuals claiming the RM50 daily hospital allowance.
MOF is using Great Eastern’s RM2 billion contribution — made in exchange for not having to divest 30 per cent of its Malaysian business to local investors — to pay back to the Singapore-based insurance company premiums for 3.69 million B40 people aged 18 to 55 for five years under mySalam, which roughly amounts to RM400 million a year, or RM100 million a quarter.
But Great Eastern has only paid out some RM350,000 for mySalam claims in about three months, 286 times smaller than the RM100 million in premiums it received.
MOF also reportedly said it was setting up information kiosks in hospitals across the country on mySalam starting only this month, even though the critical illness scheme was launched back on January 24 and opened for claims on March 1.
National Cancer Society of Malaysia (NCSM) medical director Dr Murallitharan Munisamy said doctors in government hospitals should receive a compulsory briefing on mySalam, besides putting the relevant forms on their desk so they can automatically offer them to patients.
“For example, end every consultation with a likely eligible case with the offer, ‘Have you put in a claim for mySalam? Do you think you qualify?’,” Dr Murallitharan told CodeBlue.
“Even now, there are many of our medical colleagues who are unaware of what aid is available where for which patient. It’s not really their fault as well; no one ever briefs anyone about these kind of support measures.”
Dr Murallitharan also called for mySalam notices to be put up in hospital wards and clinics, and for Great Eastern to set up desks in hospital lobbies.
“This was promised earlier and again, I’m shocked that it still hasn’t been carried out. Shows a lack of implementation and, I might even say, half-heartedness.”
When asked if the approval and application rate for mySalam was way too low, Dr Murallitharan said: “I hate to say I told you so, but I told you so.”
He said the small number of claimants reflected poor demand, which could be rectified by improving the claim submission process and having doctors promote the scheme.
“However, supply side issues reflected by the low percentage of full claims might be a reflection of the institutional resistance of insurers trained to be critically pessimistic about approving claims, as well as unclear guidelines on the approval of clams, which inevitably makes the poorly trained claims approvers unable to decide easily, causing them to always err on the side of caution in terms of their employers — the insurers, and thus deny claims.”
Parti Sosialis Malaysia (PSM) central committee member Dr Michael Jeyakumar Devaraj noted that the government has paid RM400 million for mySalam coverage this year, but only a few hundred thousand ringgit has been disbursed so far.
“I would like to know what will happen to the remainder. Will Great Eastern reimburse it to government?” he told CodeBlue.
“Looks like up till now the mySalam scheme has brought more benefit to Great Eastern than for the Malaysian public.”