INFORMATION AND EXPLANATORY LEAFLET

Dear patient,

We are pleased to welcome you as a patient at the Elisées Clinic. In order to make your stay in our establishment as comfortable and peaceful as possible we have put together some important and useful information for you. In case of any doubts please do not hesitate to contact our admission staff who will be pleased to answer your questions.

  1. The Elisées Clinic is a private medical establishment licensed in accordance with § 30 Thai law. The Elisées Clinic is an open hospital i.e. we have granted trustworthy doctors as affiliated physicians who are entitled to practice independently and treat privately insured patients. Other rules apply for our out-patient clinic department.
  2. Due to various cost-coverage agreements with private insurance companies, medical subsidy agreements or special health care allowances we advise you to raise a query in advance. For this purpose a copy of this agreement can be handed in.
  3. In case of a surgery the patient will be charged according to a fixed performance rate. This performance rate includes the accommodation costs, nursing and hospital catering. It however does not include particular additional (intensive) medical care such as the anesthesia kit and the consumed medical substances. Should several performance rates apply simultaneously, the performance costs will be reduced in order to avoid double charges.
  4. Individual hospital charges will be summed up in case none of the fixed performance rates apply in your case. The day of admission as well as the day of dismissal is each charged as an individual day.
  5. Should a patient leave the Elisées Clinic against medical advice before the set date of dismissal, the performance rate will still apply. The Elisées Clinic does not guarantee the correspondence with the granted subsidy and whether health care costs will be fully reimbursed.
  6. Should a patient wish further elective treatments a respective agreement can be made with the treating physician. The type supplementary performances and the charges are listed in the application above.
  7. In addition to the Elisées Clinic fees for rooms, operating theatre, recovery room etc. additional fees will be calculated for external necessary medical examinations and treatments – in particular laboratory, x-ray, ultrasound, CT, MRT, etc. The fees are calculated according to the Thailand physician fee ordinance which can be seen at the secretary’s desk.
  8. If the patient cancels one week before the planned start of treatment (outpatient / inpatient), a cancellation fee will be charged at an amount of 35% from the total treatment fee (this is called the cancellation fee). If a patient has already paid in advance and cancels the treatment then the cancellation fee will be deducted automatically from that amount. If certain work/ services have already been carried out for the treatment of the patient (e.g. administrative processes, patient services, physician services, laboratory services and consultations) and is cancelled by the patient then this will be billed accordingly and will also be deducted from the paid deposit. The remaining balance will be refunded to the patient. If no payments have been made​​ then the patient is obliged to pay all due amount (plus the cancellation fee package) within 2 working days, without any delays to Elisees Clinic.
  9. The Elisées Clinic reserves its right to demand advance payment. We ask for your understanding that a final invoice including all treatment costs can only be issued on the day of dismissal. We kindly ask you to cover the costs with no delay.
  10. Please acknowledge that the Elisées Clinic does not assume any liability for any valuables that have not been deposited for safekeeping at the administration.
  11. We kindly ask of you to take notice of and to support our efforts in keeping the Elisées Clinic a NON- SMOKING ESTABLISHMENT. Should you or one of your visitors wish to smoke, we kindly ask you to do this outdoors. We would also like to remind you that smoking damages your health and can interfere and impair your healing process.
  12. The Elisées Clinic makes great effort to serve your meals warm and in an appealing way. As soon as your health state allows it, we would be happy to welcome you in our dining room.
  13. We would be grateful if you could keep to the following time-schedule:
  • Breakfast: 08:30 – 09:00
  • Lunch: 12:00 – 13:00
  • Tea: 14:00 – 14:30
  • Supper: 18:30 – 19:00

14 The Elisées Clinic is strictly bound to the Data Protection Act and would like to draw your attention to the fact that personal data and all medical history will be saved.

Best wishes for a successful recovery and a comfortable stay in our clinic

FEE AGREEMENT for hospital admittance

I have taken notice of the information sheet “Elisées Clinic invoice and payment conditions” and have chosen the treatment as described above, according to the performance rates for accommodated patients dated 01.04.2012.

I was informed that every operative procedure in the Elisées Clinic is connected with a specific performance rate defined by the diagnosis at the date of admission. The performance rate includes the accommodation costs, nursing and hospital catering. I understand that the performance rate does not however include particular additional (intensive) medical care, the anesthesia kit, medicaments and consumed medical substances, nor costs for necessary external medical examinations and treatment, in particular laboratory expenses, x-ray, ultrasound, CT, MRT etc.

I hereby state that I am obliged to pay the Elisées Clinic all costs and expenses incurred during my hospital stay and that I am liable for the payment of these costs. The fees are calculated according to Thai law and the Thailand physician fee ordinance.