No cure yet for cashless medical claims impasse
The Association of Hospitals, which represents most private hospitals in the city, has asked health insurance providers to offer cashless medical insurance claims to patients at all hospitals till the differences between the two groups are resolved. HT reportsmumbai Updated: Aug 05, 2010 01:07 IST
The Association of Hospitals, which represents most private hospitals in the city, has asked health insurance providers to offer cashless medical insurance claims to patients at all hospitals till the differences between the two groups are resolved.
The root of the tussle lies in the long standing allegation that hospitals overcharge patients with cashless medical insurance. Since it’s the insurance firms that foot the bills, the patients don’t protest and the hospitals make a killing.
It’s the insurance firms that are left bearing the loss. Public insurance firms, such as New India Assurance, suffer an estimated annual loss of Rs 300 crore each because of such inflated bills.
On July 9, public insurance companies retaliated by slashing the list of hospitals in Mumbai that could offer cashless medical insurance benefits.
From the 800 hospitals in ci that could offer the facility earlier, now only 81 feature on a new Preferred Provider Network (PPN) list drawn up by insurance companies.
“A solution will take time. Meanwhile, cashless medical claims should be offered to all hospitals so that patients don’t suffer,” said Pramod Lele, CEO of P D Hinduja Hospital.
The association, represented by the heads of Jaslok, Breach Candy, Hinduja and Sir Harkisondas hospitals, said insurance companies should have consulted them before restricting cashless medical claims.
“Insurance companies, hospitals and the government must be party to such a decision. It cannot be unilateral. Many patients are suffering,” said Manesh Masand, president of the Association of Hospitals and CEO of Jaslok Hospital.
Insurance companies want hospitals to adhere to set rates for surgeries and medicine. “It’s not practical to standardise rates as the quality of service offered is different across hospitalss,” said Major General Vijay Krishna, CEO of Breach Candy Hospital.
The association said that if rates cannot be standardised, hospitals should be graded for quality of service. “We are willing to negotiate rates with insurance firms, provided a competent government authority grades hospitals based on the quality of service,” said Lele.