Concerned over the plight of patients after withdrawal of the cashless treatment facility by some hospitals at the behest of PSU insurance firms, noted heart surgeon Naresh Trehan on Monday said all-out efforts are underway to resolve the issue.
From July 1, public sector insurance companies had taken off about 150 hospitals from the list of Preferred Provider Network (PPN) that provide cashless hospitalisation services to policyholders under the mediclaim scheme.
?Patients are suffering because of the problem…we are holding meetings with different stakeholders to resolve the issue,? Trehan, who is also the chairman of the CII Healthcare Council, said.
Pointing out that the cashless treatment in certain hospitals have been withdrawn only by the four PSU insurance companies, Trehan said several meetings between the insurers and the healthcare service providers have been held.
?We would be meeting them again to resolve the issue,? he said, adding that another meeting is going to be held in Mumbai on Tuesday.
The four insurance companies ?New India Assurance, United India Insurance, National Insurance and Oriental Insurance?are believed to have stopped the cashless service because of alleged over-billing by some private hospitals.
Narottam Puri, a noted ENT specialist and member of Ficci’s committee on health services, described the steps taken by the PSU insurance companies as ?retrograde?.
He questioned how the best private hospitals in the country could suddenly become bad and taken out of the network of entities providing cashless treatment facility to insured persons.
On the allegations of over-billing, Puri had said, ?These issues can be sorted out across the table.?
However, M Ramadoss, CMD, New India Assurance, said the public sector insurers were forced to take such measures. ?We did it because we found there was no uniformity in the rates being charged by the hospitals. We observed that the hospitals were charging different rates for same kind of treatments for the same class of customers. So, we just wanted to standardise the rates being charged by the hospitals,” he said.
Ramadoss expected that the new measures from public sector general insurers wouldn’t cause any kind of inconvenience to customers as this arrangement, which was kicked off on July 1, is applicable for only network hospitals where these companies were offering cashless benefits.
?In cases, the claims are exceeding Rs 2 lakh, we are offering reimbursement later. However, let me add that hardly 35-40% cases were meant for cashless. All the remaining cases were being tackled by the third party administrators (TPAs) only,? he said.
To begin with, the public sector general insurers have reached new arrangement with 110 hospitals in New Delhi, 90 hospitals in Mumbai and 55 hospitals in Chennai. This number will go up later, he said.