Until last year, many hospitals have a structure where the double-billing patients who were covered by insurance have been subject to a higher rate. The insurance industry responded to this double-billing by introducing rate card and created a group of approved hospitals for cashless treatment is called the preferred provider network (PPN).

After the large companies between insurance face-off and hospitals last year, patients start to take advantage of the standardized cost structure in place for common medical procedures. Now, in addition, uninsured patients would not take part of the costs of hospitalization, in contrast to earlier. If inflated billing, insurance is to get hospitals to reimburse the amount overcharged for patients. The other positive is that the bill insurance claims has fallen, and this in turn will reduce the rate of pressure on health insurance and keep them under control.

The public sector insurance companies, which dominate up to 60% of the business of health insurance, managed to get most of the hospital chains in the Preferred Provider Network (PPN), in which rates are fixed for a minimum treatment 42 medical procedures. These include open-heart surgery, cataracts, knee replacement, gall bladder operations and childbirth.

"Many health care costs now carried out by health insurance is a business of Rs 11,000 crore. The four public sector companies met, increasing our bargaining power," said G Srinivasan, Chairman of the United India Insurance and theGeneral president of the Association of public sector insurers. He added that the health accounts for 26% of the activity of insurance companies generally had a lot of ground in calculating the costs of treatment and development, standardized rates.

Cashless treatment, which had problems during the uprisings last year, is back too. He is currently in 456 hospitals across NCR Delhi, Mumbai, Bangalore and Chennai. In Delhi, NCR, where 188 hospitals, including all the big names of the exception of Apollo on board, the cashless transactions now account for almost 80% of all medical insurance reimbursements. In Chennai, the figure is 60%, Bangalore and Mumbai from 55% to 20%.

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The percentage is low in Mumbai because none of the major tertiary care hospitals with high footfalls insured patients agreed to be on the nuclear plant, although the city has 114 hospitals with cashless facility. Starting this month, Calcutta, Ahmedabad, Hyderabad and Chandigarh were added to the list of cities with the possibility of cashless payment. In total, 100 hospitals are in the PPN in these four cities.

Sources said that the insurance industry, all major hospitals are, the standard prices for insured patients, although accounts differ in patients who do not have mediclaim.

Source: [ET]