Three hundred hospitals affiliated with the Ahmedabad Hospital and Nursing Homes Association (AHNA) suspended the cashless facility service for the healthcare consumers of four health insurance companies on Monday. Around 3,000 beneficiaries of New India Insurance Company Ltd, National Insurance Company Ltd, United India Insurance Company Ltd, and Oriental Insurance Company Ltd will be affected by this decision.
This, at a time, when the Insurance Regulatory and Development Authority (IRDA) guidelines called for ‘Standards and Benchmarks for the Hospitals in the Provider Network’. This would, in effect, enhance the scope for offering cashless facilities across the length and breadth of the country.
Dr Bharat Gadhvi, head of the AHNA, told Vibes of India (VO!), “Companies are not interested in providing quality medical service to their consumers. Despite rising inflation, the prices have remained constant for the last many years. PPN (Preferred Provider Network) rates should be increased by six percent every year but the price has not been increased for many years.”
Gadhvi further said that the intention was not to affect the patients. “The four insurance companies haven’t yet responded to our letter of requests to increase the PPN rates and improve the payment method. If our demands are not met, we will shut down the health insurance facilities of these companies permanently,” he said.
Dr Vasant Patel, CMO, HCG Hospital, Ahmedabad, told VO! that about 10 patients per day use the cashless facility of these insurance companies. “The patients often opt for reimbursement rather than availing of the cashless scheme,” he added.
Dr Viren Shah, Secretary of AHNA, said that surgeries and procedure charges are pre-determined by insurance companies and hospitals often do not get timely payment. Diseases such as cancer are treated with the help of modern technology, but the service charges for the same are neglected by the insurance companies.
“This fight between the insurance company and AHNA would affect the consumer who has paid the premium for the cashless scheme. At the time of charging the premium, the insurance company suggests to the customer the hospitals in which the cashless facility would be available. The condition of the agreement between the hospital and the insurance company becomes important in such a situation,” said advocate Jamir Shaikh of Gujarat High Court.
Ami Marwar, CEO of AIMS Hospital, Ahmedabad, has clarified that the emergency services will continue as before.
Read More: AHNA Withdraws Insurance Companies Cashless Facility, Affects 3000 Patients