E- MEDITEK – beyond insurance contracted amount

My wife Smt.RINA BHATTACHARYA was admitted in Zenith Super Speciality hospital for both knee repacement on 7.12.2013 & discharged on 18.12.2013. Before the admission the surgeon Dr. Nantu Saha explained the procedure and the cost related to it. He assured and promised that the cost will be within our Insurance payment limit as he knows and will confirm with my insurance about the payment limit. 1.Hospital charges paid by E-Meditek – Rs.2,90,000.00 2. Hospital charges paid by me -Rs.56,330.00 3.Pre Hospitalisation paid by me – Rs.1425.00 4.Post Hospitalisation charges paid by me-Rs.8993.0 Total paid by me -Rs.66,748.00 Claim no. 10111317637 Policy no. OG -13-1000-8402-00000001 MIN no. 04101081 From final bill Rs.21,434.00 received deducting Rs.45,314/- for excess charge by Zenith S S Hospital against Orthopaedic Implant(nibso metals pvt. ltd) used cost of Rs.90,000/ in place of agreed charge Rs.75,000/-.Less money received Rs.45,314/-from Insure company. Enquired from E- MEDITEK &SAIL cause of less payment.Both replied Hospital Surgeon Dr. Nantu Saha did not follow their guide lines for which patient party is to suffer. When contacted Dr. Saha for the first time after the surgery about the claim amount he said that he doesn’t follow the insurance limit because he thinks the material that he has implanted in the knees are better quality even though they are expensive and more than the insurance limits. Last week when I contacted him again then he said if he had known about the insurance limits then he would have used the less expensive ones. So every time he is changing his reason for using the implants. Now what a customer expects from Hospital authority.? It s not our fault. Then why I will lose such an amount? **For ur information my wife still can not stand on her feet.Last 5 months I am paying extra money against Phisiotherapist. They are appointed by the Doctor. Hope you wiil sympathetically consider and favourable action will be taken from your side . Regards. Achintya kr. Bhattacharya (Husband of Rina Bhattacharya)

I would like the hospital and the Surgeon should take the responsibility for the extra charges for implants and return the amount that I paid out of my own pocket.

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