MUMBAI: Health insurance policyholders are again witnessing sporadic cases of suspension of cashless hospitalization as hospitals and insurers spar over the issue of tariff rates for medical treatments. In a fresh incident, the Association of Healthcare Providers India (AHPI), a body of over 15000 hospitals, threatened to suspend cashless services for Star Health Insurance policyholders from September 22. In turn, the General Insurance Council (the association of non-life insurers) has asked AHPI to return to the negotiating table and ensure uninterrupted care for patients. Last month, Niva Bupa Health Insurance suspended cashless treatment facility at Max Hospitals. Cashless treatment is also unavailable at Max Hospitals for policyholders of several other insurance companies. Ironically, these developments come at a time when the Insurance Regulatory and Development Authority of India (IRDAI) is pushing for 100 per cent cashless treatment across India. So, what are the options available to policyholders if an insurer or hospital suspends cashless hospitalization to a hospital where he had planned to take treatment?1.Choose Reimbursement—The first and most obvious option is to go for reimbursement mode. Here, you will need to pay out-of-pocket for the hospitalization and then file for reimbursement with your insurer. Insurers set up priority reimbursement process for customers who are currently undergoing or seeking treatment at a hospital where cashless treatment has been suspended.2.Look at other network hospitals—Policyholders wanting to avail cashless treatment can opt for any other network hospital from the list of thousands of hospitals available on his insurer’s website.However, your treating doctor may or may not be available at the network hospital.3.Check if treatment can be done in daycare—Says Nisha Sanghavi, director at Promore Fintech, “Check with your insurance company if the hospitalization can be converted to daycare treatment. For example, Varicose veins traditionally required hospitalization but insurers are now allowing the procedure for varicose veins to be done under daycare which saves policyholders from the hassle of hospitalization.”4.Beware of Blacklisted hospitals— These are hospitals that indulge in inflated or fraudulent billing and have been blacklisted by insurers. The blacklisted hospital list is available on the insurancecompany’s website. Insurers will not honor any claim be it cashless or reimbursement for treatment taken in a blacklisted hospital.5.Don’t consider porting— Says Shilpa Arora, chief operating officer and co-founder of Insurance Samadhan, “There may be certain policyholders who may evaluate porting to some other insurer but it could result in loss of certain benefits besides fresh waiting periods for pre-existing diseases may also apply.”6.Check your bill—With cases of rampant overcharging of insured patients by hospitals and doctors, you need to be wary of the hospital bill handed to you. Check if the number of times you have been charged for doctor visits and the actual number of times a doctor actually visited your match. Look for multiple charging for the same items, tests, medicines or procedures.
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पूर्वी गोदावरी में बाढ़ के पानी ने सड़कों को काट दिया, गुंटूर के निचले क्षेत्रों में पानी भर गया है।
विशाखापत्तनम: पूर्वी गोदावरी जिले के टल्लपलेम और कंसलपलेम क्षेत्रों में बाढ़ के पानी और धाराएं सड़कों पर बहने…
