Health Insurance Experts Blog

Hospitals in Mumbai unite against Health insurers

Hospitals in Mumbai against insurers Healthcare providers in Mumbai formed a core committee on Friday to deal with the controversial preferred provider network (PPN) programme unilaterally introduced by public sector general insurance companies under the cashless mediclaim facility.  “The rate for a procedure of cataract is about Rs24,000 under the PPN,” said Dr Sujata Rao, president of the AMC. Thus the maximum reimbursement that a . . .

TPAs to move Competition Commission against PSU Insurance Cos.

TPAs to move competition panel against PSU insurers The association of third party administrators (TPA) has decided to move the Competition Commission of India (CCI) against the four public sector non-life insurance companies and their association, called General Insurers Public Sector Association of India (Gipsa), for forming a cartel and abusing their dominant market position in planning their own TPA outfit. “The TPA floated by Gipsa companies will . . .

Mechanisms like Uniform Claim form will improve efficiency

IRDA plans new health insurance rules On Monday, J Harinarayan, Chairman, IRDA said “The mechanisms are being put in place to improve efficiency in health insurance and administration. Expert committees of industry bodies like CII and FICCI have recommended measures including uniform claim forms, re-authorization. We are also looking into aspects related to billing,” he said. As of July 1 328 hospitals were in the network for . . .

IRDA to follow HC direction on resuming cashless facility

IRDA to follow HC direction on resuming cashless facility Insurance regulator IRDA today said it will follow the Delhi High Courts direction to take steps on resuming cashless facility to policyholders provided by four PSU general insurers. Now that HC has given direction, we will follow that, IRDA Chairman J. Hari Narayan told reporters on the sidelines of a FICCI event here. On Tuesday, the Delhi High Court had asked IRDA . . .

Creation of a Health Fund for Medical Emergencies in the Cashless Chaos

Medical exigencies and an empty wallet When faced with a medical emergency, you pay cash or use your credit card, instead of asking why the hospital is not accepting your cashless medical insurance. This is exactly what harassed consumers found out when health insurance companies recently stopped cashless treatment making customers pay first and then get reimbursed. Health insurers blamed private hospitals of inflating bills that were . . .

Are uniform rates for Medical procedures plausible for Insurance Claims?

Cashless mediclaim policy Pvt hospitals seek government help The association of private hospitals have sought state government’s intervention to settle the ongoing dispute with insurance companies over cashless mediclaim policy. The association, which includes hospitals like Jalok, Breach Candy, Hinduja and Hurkisondas, has said that the demands of uniform rates for medical procedures that had been put forth by insurance firms were not plausible. “Rates differ according to available . . .

Insurance Cos. give deadline to Large Hospitals for standardizing rates for cashless claims

10-day time limit for hospital NEW DELHI: The standoff between insurance companies and private hospitals over cashless treatment continues, defying hopes of millions of Mediclaim policy holders for an early resolution. The four major public sector health insurance companies, which control 80% of the business, have now set a 10-day deadline for four major chains of hospitals — Apollo, Fortis, Max and Medanta — . . .

Competition Commission of India to investigate cashless mediclaim issue

CCI to investigate cashless mediclaim issue The Competition Commission of India (CCI) may take up the cause for consumers who have been hit hard due to the new arrangement entered into by leading insurance companies. In the new arrangement, the insurance companies will stop making direct payments to hospitals on behalf of their policy holders a pre-requisite as per the cashless mediclaim policy they offer. According to . . .

Health Insurance Companies to extend cashless facility in emergency and trauma cases

Health Insurance Companies to extend cashless facility in emergency and trauma cases MUMBAI: In a major relief to health insurance policy-holders, public sector insurance companies have announced that cashless treatment will be extended to all hospitals in emergency and trauma cases. During a healthcare meeting with the Confederation of Indian Industries (CII) in New Delhi on Friday, New India Assurance Company chairman M Ramadoss said a patient who requires emergency and . . .

Feasibility of Health Insurance Companies buying equipment directly?

Insurers to buy equipment MUMBAI: After curtailing the list of hospitals eligible for cashless mediclaim, public sector health insurance companies are going further by proposing to order and pay for medicines and medical equipment themselves. They claim the move would help reduce the cost of medication and equipment by at least 20-30% in cashless claims, as hospitals are overcharging for the same. The . . .

RecentComments


SUPER SERVICE
Category
Medimanage in News