Hospital bodies' core panel will deal with insurers
Members of four major associations of hospitals and medical professionals in the city met on Friday to decide that none of their member hospitals would independently interact with the General Insurers Public Sector Association (GIPSA).mumbai Updated: Aug 21, 2010 01:59 IST
Members of four major associations of hospitals and medical professionals in the city met on Friday to decide that none of their member hospitals would independently interact with the General Insurers Public Sector Association (GIPSA).
The decision comes two days after the GIPSA announced a fixed price package for cashless medical insurance.
Only a core committee, consisting of senior members of the Association of Hospitals (AOH), Bombay Nursing Homes Association (BNHA), Association of Medical Consultants (AMC), and the Bombay Ophthalmologists Association (BOA) will now communicate with insurance company and third party administrator (TPA) representatives about the issue of cashless medical insurance.
"We will release a letter to the GIPSA on Monday, requesting them to only deal with the core committee and meet again to decide on the future course of action," said Major General (retd) Vijay Krishna, CEO, Breach Candy Hospital, who is heading the core committee.
The AOH, which consists of 56 city hospitals, stated that none of their members had agreed to the price package that had been worked out by public sector insurers and TPAs for cashless insurance.
"One of our member hospitals, Inlaks General Hospital in Chembur, was even falsely listed in a newspaper report on Friday as having accepted the insurers’ price package and being accorded a certain grade. But the hospital’s CEO tells me they haven’t interacted with insurers or TPAs at all," said Colonel Manesh Masand, CEO of Jaslok Hospital and president of the AOH.
However, a senior GIPSA official said about 122 hospitals were now part of the Preferred Provider Network (PPN) that could offer cashless medical insurance to their patients.
"On July 1, about 80 hospitals were part of the PPN. We have most major hospitals on board now. It’s only a few major hospitals that are yet to agree to the price package," the official said.
According to Dr Mohammed Mukhtar, project head for GIPSA-PPN and a senior TPA official, the fixed price package will grade hospitals into four categories: A+, A, B and C on the basis of the facilities they provide.
"We are yet to fix the final working rates. While hospitals graded A, B and C will have same rates, there could be a 2-3 per cent margin between treatment prices of hospitals in the A+ category, as quality of service for the same treatment can differ in top hospitals," said Mukhtar.