Health Insurance Experts Blog

Cashless Chaos: Making Sense of it All

Cashles Chaos: Making sense of it all News Flash:  “The General Insurance Public Sector Association consisting of four major state-run insurance companies - United India, New India, Oriental Insurance and National Insurance have decided to stop cash-less hospitalization in most hospitals” Shock and outrage are the two words that describe the reaction of most of the customers and media reports on this piece of news.  We demanded to . . .

Medimanage Opinion: 50% Extra Premium on Mediclaim for treatment at high-end Hospitals

50 % extra premium to get treatment at high-end hospitals You might have to shell out 50 per cent extra premium to get treatment at the country’s high-end hospitals. Following the uproar over withdrawing cashless health insurance claims from high-end hospitals, state-owned non-life insurers are working on a product with differential rating that will bare the expenses of the top hospitals. The four insurers – New India Assurance, United India Insurance, National . . .

PSU Insurers: Fix rates or get delisted from our Cashless Network.

Insurers may expand the list of hospitals for cashless facility. NEW DELHI: Locked in a battle with big healthcare firms over censoring cashless health insurance claims, state-run insurers on Thursday asserted that the facility would be extended only to those hospitals that agree to their rates for medical expenses. "The purpose of working out such package rates and stabilising the hospitalisation costs, will benefit the insured in many ways," . . .

How will Common TPA for PSU Insurers impact consumers and health insurance industry?

Recently, we came across news in an online Publication, in.news.yahoo.com Common TPA to process the health insurance claimsRecently, we came across news in an online Publication, in.news.yahoo.com Chennai, July 11 (IANS) The four government-owned non-life insurers -- National Insurance, New India Assurance, Oriental Insurance and United India Insurance-- will soon be taking forward their idea of floating a common third party administrator (TPA) to process the health insurance claims. 'We will be issuing a Request for Proposal (RFP) shortly. . . .

Health Insurance Claims may get delayed, as I-T dept seal TPA accounts

Recently, we came across news in an online Publication, mydigitalfc.com Health insurance policyholders may face problems as I-T dept seals TPA accountsRecently, we came across news in an online Publication, mydigitalfc.com Several health insurance policyholders may face problems in getting cashless hospitalisation as the income tax department has sealed accounts of several third party intermediaries (TPAs) for non-payment of tax deducted at source (TDS). Industry officials say TPAs whose accounts have been sealed are Mumbai headquartered Pa­ramount Health Services, United Healthcare Services, . . .

Corporate Hospitals criticize withdrawal of cashless service for Mediclaim.

Recently, we came across news in an online Publication, business-standard.com Withdrawal of cashless service for Mediclaim.Recently, we came across news in an online Publication, business-standard.com The decision by public sector health insurance companies to deny cashless services to their clients has been criticised by Fortis, a leading corporate healthcare chain. Chains such as Fortis generate a significant portion of their revenue through health insurance policy reimbursements. The Federation of Indian Chambers of Commerce and Industry was also critical. . . .

Why do Hospitals overcharge Cashless Health Insurance Claims?

Hospitals overcharging Patients under Cashless Claims is under the media buzz since a few days. Here is a quick post which reasons why Hospitals overcharge Cashless Claims: No Contracted Rates with Hospitals: TPAs do not have contract binding rates (treatment-wise) with Hospitals in their network. Globally, TPAs contract treatment-wise rates with each Hospital in their network. Treatment wise fixed rates would remove the disparities and anomalies that Hospitals currently enjoy. The core of the issue is TPAs lack negotiation power with Hospitals. Hospitals overcharging Patients under Cashless Claims is under the media buzz since a few days. Here is a quick post which reasons why Hospitals overcharge Cashless Claims: No Contracted Rates with Hospitals: TPAs do not have contract binding rates (treatment-wise) with Hospitals in their network. Globally, TPAs contract treatment-wise rates with each Hospital in their network. Treatment wise fixed rates . . .

Analyzing Future of Cashless Mediclaim in India

analyzing future of cashless mediclaim in India Preamble Last 3-4 days, we have been seeing a lot of news in various media about cashless network hospital list being brought down to fewer in numbers & this list does not have big hospitals where the treatment cost is high & hence, have a greater need for their presence in list. We fear that these news items have created . . .

Medimanage Exclusive: Analyzing PSU Health Insurers delisting Popular Hospitals!

Financial losses by health insruance company Health insurance companies are trying to salvage the losses which are just increasing each year and here is another of their moves. Public Health insurance Companies (Oriental, New India Assurance, United, National) have announced that they are taking down large number of the hospitals from their list of network hospitals to access Cashless service. From the 800 hospitals which were . . .

60 Million Insured under National Rural Health Insurance (RSBY)

Recently, we came across news in an online Publication, hindustantimes.com Rashtriya Swasthya Bima YojanaRecently, we came across news in an online Publication, hindustantimes.com In 26 months, RSBY has enrolled more than 60 million people in 22 states; by next year that should double to 100 million. This is the first use, on this scale, of India's technology prowess to run a national socal-security programme. If RSBY succeeds, it could be the precursor for reforms . . .

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