Hospitals' body to discuss cashless insurance package
The Association of Hospitals (AOH), Mumbai, has decided to meet on Friday to discuss fixed rates for medical procedures as determined by insurers.mumbai Updated: Aug 20, 2010 02:13 IST
The Association of Hospitals (AOH), Mumbai, has decided to meet on Friday to discuss fixed rates for medical procedures as determined by insurers.
On Wednesday, public sector insurers and third-party administrators had worked out cashless insurance hospitalisation price package. According to this three-tier package, hospitals have been divided into three groups — category A, B and C — based on infrastructure facilities, and prices for 42 medical procedures have been fixed, depending on the category a hospital belongs to.
The association members claimed that there has been no dialogue so far between the public sector insurance companies and major hospitals in the city.
"We haven't been informed about the three-tier package. We first read about it in newspaper reports. The AOH will meet to discuss the matter," said Pramod Lele, CEO, PD Hinduja Hospital, a member of the AOH.
Major hospitals in the city, including Breach Candy, PD Hinduja and Dr LH Hiranandani, are not in favour of the three-tier price package.
They are also against the prices that have been fixed.
"The rates for the three-tier package do not take into account the operating costs and doctor fees in a realistic way. They need to be re-examined," said Major Gen. (retd), Vijay Krishna, vice-president, AOH, and CEO of Breach Candy Hospital.
Hospitals also feel that the rates do not take into account the type or class or room that patients occupy.
"Hospitals have different types of rooms, from a general ward to a deluxe room. How we can expect the rates to be the same for these?" asked Lele.
But the public sector insurers are not convinced.
"The hospitals are used to charging exorbitant rates, it will take them time to agree to this package. But if hospital rates continue to escalate the way they do, health insurance could soon become unaffordable," said an official of the General Insurers Public Sector Association, on condition on anonymity.