The four government-owned general insurance companies that have limited the availability of cashless hospitalisation to those hospitals that agree to their rates would now look at raising their cap on treatment cost to bring in more hospitals under the new system.
In a meeting on Tuesday, members of the CII National Committee on Healthcare that include top private hospitals met chiefs of the four companies (New India Assurance, Oriental Insurance, United India Insurance and National Insurance Company) to discuss the preferred provider network project of the insurers that has categorised and graded hospitals and capped the rates for 43 odd surgeries in Delhi, Mumbai, Bangalore and Chennai.
Meanwhile, the Insurance Regulatory & Development Authority (Irda) has written to the four companies asking them as to why cashless has been stopped for retail policyholders and not for corporate policyholder. Insurers have been asked to submit a report in the next 48 hours explaining the basis of launching the preferred provider network project.
Financial Chronicle on July 5 was the first to report that the four government owned non-life insurance companies have graded hospitals and fixed the treatment cost for various 45 surgeries. Hospitals that have agreed to the new rates would be able to provide cashless facility to the policyholders.
A senior official of one of the four insurers who attended the meeting said, “There could be some reconsideration of rates so that there could be a better representation of corporate hospitals on the panel. In the next 90 days we would look at addressing all areas of concern.”
Vishal Bali, CEO of Fortis Hospitals, told Financial Chronicle, “We had three agendas to discuss. One, to grow the preferred provider network by adding more hospitals, relook at the categorisation and pricing of treatments. Insurers have said that they will ask their respective third party administrators (TPAs) to hold discussions with hospitals and try to bring in more hospitals in the network.”
“We have also suggested that instead of setting price bands for various treatment based on the categorisation of a hospital, a better solution would be to introduce a system of co-payment if the policyholder wants to be treated in top hospital. Thus, the onus of using the cover is equally shared by all including the policyholder,” said Bali. Co-payment is a system where an amount of the claim is borne by the policyholder.
“Insurance companies have said that they are willing to look at the price band of treatments at high end hospitals,” said Bali.
In a meeting on Tuesday, members of the CII National Committee on Healthcare that include top private hospitals met chiefs of the four companies (New India Assurance, Oriental Insurance, United India Insurance and National Insurance Company) to discuss the preferred provider network project of the insurers that has categorised and graded hospitals and capped the rates for 43 odd surgeries in Delhi, Mumbai, Bangalore and Chennai.
Meanwhile, the Insurance Regulatory & Development Authority (Irda) has written to the four companies asking them as to why cashless has been stopped for retail policyholders and not for corporate policyholder. Insurers have been asked to submit a report in the next 48 hours explaining the basis of launching the preferred provider network project.
Financial Chronicle on July 5 was the first to report that the four government owned non-life insurance companies have graded hospitals and fixed the treatment cost for various 45 surgeries. Hospitals that have agreed to the new rates would be able to provide cashless facility to the policyholders.
A senior official of one of the four insurers who attended the meeting said, “There could be some reconsideration of rates so that there could be a better representation of corporate hospitals on the panel. In the next 90 days we would look at addressing all areas of concern.”
Vishal Bali, CEO of Fortis Hospitals, told Financial Chronicle, “We had three agendas to discuss. One, to grow the preferred provider network by adding more hospitals, relook at the categorisation and pricing of treatments. Insurers have said that they will ask their respective third party administrators (TPAs) to hold discussions with hospitals and try to bring in more hospitals in the network.”
“We have also suggested that instead of setting price bands for various treatment based on the categorisation of a hospital, a better solution would be to introduce a system of co-payment if the policyholder wants to be treated in top hospital. Thus, the onus of using the cover is equally shared by all including the policyholder,” said Bali. Co-payment is a system where an amount of the claim is borne by the policyholder.
“Insurance companies have said that they are willing to look at the price band of treatments at high end hospitals,” said Bali.
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