Solution to cashless treatment facility remains elusive

PUNE: The deadlock over cashless treatment for health insurance policyholders continues, as the marathon meeting held between top ministry, insurance officials and hospital representatives here on Monday failed to yield a solution.

The meeting, however, was instrumental in bridging the communication gap between city hospital owners and top officials, with hospital owners being able to air their grievances and demands.

“The authorities took stock of our difficulties. We told them that we have not received a satisfactory response as to on what grounds hospitals are graded and classified. They told us that they would look into the issue. They told us that an amicable solution needs to be found in public interest. But over all, the meeting failed to yield any solution to the current impasse over cashless facility,” said Manjusha Kulkarni, secretary of the Association of Hospitals, an umbrella organisation of 38 big hospitals in Pune and Pimpri Chinchwad

Orthopaedic surgeon Nitin Bhagali of the hospital wing of Indian Medical Association (IMA) shared this view. “The authorities from the finance ministry and insurance companies gave a patient hearing to our grievances and understood our demands. The meeting may have failed to find a definite solution, but it has certainly bridged the communication gap between top ministry and insurance authorities and hospital owners. They also came to know about the ground realities in Pune.”

N Shrinivas Rao, director (insurance), Union ministry of finance, A K Singhal, chief executive officer of General Insurance Public Sector Association (GIPSA), Vasant Krishna, general manager of National Insurance Company, and six divisional general managers from Chennai, Kolkata, Mumbai and Delhi attended the meeting with over 70 hospital representatives.

At present, only 10 of the 38 big hospitals in Pune have been offered 21% hike in the fixed treatment rate plan floated by public sector insurance companies. The remaining 28 hospitals covered by the Association of Hospitals have also demanded a 21% hike in treatment rates, as against the 7% hike offered to them by the third party administrators.

Of the 10 hospital, only Ruby Hall Clinic and Noble Hospital have signed the agreement so far. The remaining eight hospitals are in the process of completing the formalities. The other 28 big hospitals in Pune have not been offered any hike in treatment rates so far. Over 100 smaller hospitals have stopped providing the cashless treatment facility as they have not been offered any hike in treatment rates.

Public sector insurance companies — the New India Assurance Company, the United India Insurance Company, Oriental Insurance Company and National Insurance Company — sell nearly 80% of the health insurance policies in the country under the banner of GIPSA. They had floated fixed rates for various medical procedures in metros three years ago and are now extending them to Pune and other tier II cities.

All the four public sector insurance companies had published notices in newspapers on November 28 last year, in which they clearly stated that cashless facility should be provided to emergency and trauma cases even at hospitals which are not part of the preferred provider network (PPN).

Curated From : Solution to cashless treatment facility remains elusive

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