Many private hospitals resume cashless mediclaim facility

PUNE: Many big private hospitals in the city have resumed offering cashless mediclaim of public sector insurance firms after “one-on-one negotiations”.
The move comes as a huge relief to a host of insured patients who are currently forced to raise money to pay their hospital bills and get the amount reimbursed from their insurance companies later.
Most private big hospitals in the city had stopped offering cashless mediclaim of public sector insurance firms in April this year after the latter failed to revise the “low rates” offered to the hospitals.
Sahyadri Hospital, Aditya Birla Memorial Hospital, Columbia Asia Hospital, Inlaks and Budhrani Hospital, Oyster and Pearl Hospital and Jehangir Hospital have accepted the insurance companies’ rates. Other hospitals like Ruby Hall Clinic, Poona Hospital, and Sancheti Hospital are yet to resume the facility. However, sources from the private health sector exuded confidence that the remaining hospitals will renew their contracts soon.
“After negotiations with insurance authorities for the last three to four months, we have got reasonably good increase in rate, after which we started the cashless mediclaim facility,” George Eapen, chief executive officer of Jehangir hospital, said.
Madhur Varma, CEO, Sahyadri Hospitals, declined to share rates offered by the public sector insurance firms.”However, it is sufficient to say that reasonable increase has been given to our hospitals.They (the insurance authorities) have also increased number of single line packages for frequently done procedures,” Varma added.
Viju Rajan, CEO of Columbia Asia Hospital in Kharadi, also admitted of getting slight increase in rates. “We signed up the contract after getting slight increase in rates,’ he said.
Gynaecologist Amita Phadnis, director, Oyster and Pearl hospital, said, “We have signed up the contract with the public sector insurance firms and resumed cashless facility for our patients’ convenience.’
When contacted Bomi Bhote, CEO of Ruby Hall Clinic, said, “We have not signed up the contract simply because the rates offered to us are unacceptable. Besides, we have worked out finance scheme for needy patients.” Bhote is also the president of the Association of Hospitals in Pune. As many as 38 big hospitals in Pune and Pimpri Chinchwad are members of the association.
The stalemate between the hospitals and the insurance firms is over the rates of 64 surgical procedures. “The rates offered by the insurance firms to hospitals for these procedures are ridiculously low. They do not even cover the fees of consultants and surgeons let alone the hospital bill,” Bhote said Orthopaedic surgeon Nitin Bhagli said, “They (public sector insurance firms) have created a monopoly of big and corporate hospitals by including them in preferred provider network whose bills (and hence the outgo for settlement of claims) are distinctly more than smaller hospitals which are kept outside the network.” Despite repeated attempts, officials from General Insurance Public Sector Association (GIPSA) could not be contacted for their comments.
Rate difference
George Eapen, CEO of Jehangir hospital raised the issue of the difference between rates offered to metros against non-metros.
“This difference is huge.Angiogram in Chennai is offered at Rs 30,000 whereas as we get only Rs 15,000 from the insurance firms. Although the premium paid by patients across India is the same. Under the new regime, we want to serve our patients with renovated rooms, upgraded facilities, faster admission and discharges.Besides, we have also started offering zero percent loan facility to non-affording and insurance declined patients,” Eapen said.

source:timesofindia