More nursing homes in Mumbai will soon provide cashless insurance treatments, as the Association of Medical Consultants (AMC) is set to create a cell to ease the paperwork required in such cases.
A cashless medical insurance implies that in case the insured person is hospitalised in any of the network hospitals, the claim is settled by the health insurance company directly with the hospital.
The AMC has formed a body, the Network of AMC Hospitals (NoAH), to help private and public sector insurance companies come together so that patients can avail of cashless insurance treatment.
The NoAH has also partnered with an outsourced knowledge partner who will handle the authorisation process.
Since 2010, nursing homes have not been offering cashless insurance treatment for its patients.
“The cell will deal exclusively with the problems associated with nursing homes. It will be a self-regulated group which will promote uniform billing standards and voluntary accreditation.
"170 of the 217 members attached with NoAH already have accreditation. We are in talks with the other insurance companies,” said Dr Sudhir Naik, chairperson, NoAH.
The lack of cashless insurance was driving nursing home patients to hospitals, said doctors.
“Many people are going straight to private hospitals because they have the option of cashless insurance. However, what they do not realise is that in the bargain, the claims are higher,” said Dr Sangeeta Pikale, convener, NoAH.
The nursing homes that have not been accreditated yet have promised to do so in a year.
The nursing homes under NoAH will have a common billing format, common insurance and cashless procedural format, and will display the tariff of services provided in the nursing homes.
“They will not have the problem of following up on paper work. This will benefit the nursing home, insurance company and the patient,” said Dr Naik.