Description : Industry
Date : Aug-13-2010
The cashless treatment facility by PSU insurers is expected to be reinstated fully in city hospitals within a week.
It was suspended since July.
But, however, the insured may have to pay higher premiums for treatment in super specialty medical centers.
Meanwhile, soon, each hospital will work out a package rate with the TPAs.
These are the facilitators between the insured and the insurer.
IRDA Chairman J Hari Narayan, however, stated that the costs of treatment can differ from hospital to hospital in the coming days.
On the other hand, from July 1, the public sector insurance companies had taken off about 150 hospitals from the list of preferred provider network (PPN).
These provide cashless hospitalization services to policy holders under the mediclaim scheme.
Earlier, some hospitals had withdrawn the cashless insurance facility following the command of some PSU insurance firms.
This move has drawn concern over the plight of patients according to noted heart surgeon Naresh Trehan today and there are continuing efforts towards the restoration of the process.
Addressing the matter, the chairman of the CII Healthcare Council, Trehan said, "Patents are suffering because of the problem...We are holding meetings with different stakeholders to resolve the issue."
About 150 hospitals that offer hospitalistation services cashless to the policyholders under the mediclaim scheme have been dropped off by the public sector insurance providers from July 1st.
Four insurance providers inclusing New India Assurance, United India Insurance, National Insurance and Oriental Insurance have taken the step over the alleged over billing by some private hospitals.
Trehan has pointed out the matter that only four PSU insurance providers have stopped cashless services and several rounds of meetings are being held between the insurers and the healthcare service providers.
Initially they started with excluding some facility in select private hospitals in four metropolises-Delhi (National Capital Region), Mumbai, Bangalore and Chennai, as reported by an executive with national insurance company.
Referring to this the official said, "We were constrained to take this decision as it was realised that health insurance firms have been shelling out more towards mediclaim than the premium they are earning."
Agreeing to it CEO and MD of Bharti AXA General Insurance Company Amarnath Ananthanarayanan said, "We had tied up with nearly 4,000 hospitals in the country for the cashless treatment but from July 1 we have de-paneled 200 hospitals.
We were forced to take this step because these hospitals were overcharging patients, making them undergo unnecessary tests and medical treatments mainly to inflate the hospital bills."
Referring to the PSU insurance companies move as retrograde a noted ENT specialist Narottam Puri, member of Ficci's committee on health services questioned on the sudden move to consider some of the best insurance hospitals as bad and the basis of taking them out of the list suddenly.
Over the issues related to over billing, he said, "These issues can be sorted out across the table."
The ire of the insurance companies has led them to demand the hospitals through their TPAs (Third Party Administrators, who process the insurance claims from hospitals), to cut down the billing by almost 20 to 40 per cent.
However, the hospitals declined to agree that was followed by about 200 hospitals coming out of the list.
Date : Aug-13-2010
The cashless treatment facility by PSU insurers is expected to be reinstated fully in city hospitals within a week.
It was suspended since July.
But, however, the insured may have to pay higher premiums for treatment in super specialty medical centers.
Meanwhile, soon, each hospital will work out a package rate with the TPAs.
These are the facilitators between the insured and the insurer.
IRDA Chairman J Hari Narayan, however, stated that the costs of treatment can differ from hospital to hospital in the coming days.
On the other hand, from July 1, the public sector insurance companies had taken off about 150 hospitals from the list of preferred provider network (PPN).
These provide cashless hospitalization services to policy holders under the mediclaim scheme.
Earlier, some hospitals had withdrawn the cashless insurance facility following the command of some PSU insurance firms.
This move has drawn concern over the plight of patients according to noted heart surgeon Naresh Trehan today and there are continuing efforts towards the restoration of the process.
Addressing the matter, the chairman of the CII Healthcare Council, Trehan said, "Patents are suffering because of the problem...We are holding meetings with different stakeholders to resolve the issue."
About 150 hospitals that offer hospitalistation services cashless to the policyholders under the mediclaim scheme have been dropped off by the public sector insurance providers from July 1st.
Four insurance providers inclusing New India Assurance, United India Insurance, National Insurance and Oriental Insurance have taken the step over the alleged over billing by some private hospitals.
Trehan has pointed out the matter that only four PSU insurance providers have stopped cashless services and several rounds of meetings are being held between the insurers and the healthcare service providers.
Initially they started with excluding some facility in select private hospitals in four metropolises-Delhi (National Capital Region), Mumbai, Bangalore and Chennai, as reported by an executive with national insurance company.
Referring to this the official said, "We were constrained to take this decision as it was realised that health insurance firms have been shelling out more towards mediclaim than the premium they are earning."
Agreeing to it CEO and MD of Bharti AXA General Insurance Company Amarnath Ananthanarayanan said, "We had tied up with nearly 4,000 hospitals in the country for the cashless treatment but from July 1 we have de-paneled 200 hospitals.
We were forced to take this step because these hospitals were overcharging patients, making them undergo unnecessary tests and medical treatments mainly to inflate the hospital bills."
Referring to the PSU insurance companies move as retrograde a noted ENT specialist Narottam Puri, member of Ficci's committee on health services questioned on the sudden move to consider some of the best insurance hospitals as bad and the basis of taking them out of the list suddenly.
Over the issues related to over billing, he said, "These issues can be sorted out across the table."
The ire of the insurance companies has led them to demand the hospitals through their TPAs (Third Party Administrators, who process the insurance claims from hospitals), to cut down the billing by almost 20 to 40 per cent.
However, the hospitals declined to agree that was followed by about 200 hospitals coming out of the list.
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