The recent directive of the Insurance Regulatory and Development Authority of India (IRDAI) on Ayushman Bharat Digital Mission (ABDM) adoption by doctors would make it easy for the insurance companies to include the benefit of OPD cover in the health insurance policies.
As a part of ABDM, the IRDAI has advised making a Healthcare Professional Registry (HPR) for building up the network of doctors, medical practitioners and healthcare professionals. The HPR would facilitate the insurers to develop a network of the empaneled doctors, visit to whom would either be cashless, or the fees paid to such doctors would be reimbursed to the insured persons.
“With the introduction of the Healthcare Professional ID (HPID) the healthcare ecosystem will witness unparalleled transparency and seamless flow of information among all the stakeholders such as insurers, TPA, doctors and even the policyholders. The insurance regulator has advised making the best use of the Healthcare Professional Registry (HPR) for building up the network of doctors, medical practitioners and healthcare professionals to further enable wider OPD coverage within the health insurance policy. This mission is envisioned to increase insurance penetration in India by effectively trying to address customer expectations and continuous product innovation to reach a wider customer base,” said Amit Chhabra, Head – Health Insurance, Policybazaar.com.
“Moreover, this will also make it easier for medical practitioners to buy professional indemnity cover for themselves, protecting them against cases of incorrect treatment, negligent misdiagnosis, etc,” he added.
According to Satish Gidugu, CEO, Medi Assist, “Healthcare providers are important participants in delivering services to insured customers. A significant emphasis for the insurance industry is to enable access to reliable and good quality healthcare providers to deliver the best medical care. HPR will give a big boost to OPD insurance products.”
“We’re excited about the opportunity as this will lead to better customer experience through a network of vetted medical professionals,” he added.
So, as a health insurance policyholder, when you visit a doctor next time in an Out Patient Department (OPD), you won’t have to pay anything, provided the OPD benefit is included as a feature in your policy, and you have opted for it.