16 July 2010
By Pradeep Thakur New Delhi, India
In the first sign of high–end hospitals yielding to pressure from insurers to rein in their charges, at least 50 in Delhi and the national capital region–including Ganga Ram and the Metro chain–have in the last five days signed package deals with insurance companies to continue to benefit from the cashless mediclaim facility. Insurers had stopped direct payments to them from July 1, 2010, claiming they were over–billing.
Major hospital chains–including Apollo, Fortis, Ganga Ram, Max, Metro and Medicity–had then protested and refused to sign the new package deals that meant accepting much lower charges for treatments than their existing rates.
“Apollo and Moolchand have expressed keenness to get on board, while we have asked CEOs and CFOs of other major hospitals to give their rates. We may show some flexibility depending on the facilities they provide,” said Pawan Bhalla, CEO of Raksha TPA, the third party administrator which is a facilitator between the insured and the insurer.
Health Cheque
- At least 50 hospitals in Delhi and NCR, including Ganga Ram and Metro chain, have signed new package deals
- Some flexibility on rates may be allowed to hospitals based on facilities provided by them
- CEOs of major hospital chains to meet today to reach consensus on package
New Delhi: Four major PSU insurers, which command 60%–70% market share in health insurance, dug their heels in on Thursday and said hospitals would have to agree to the package deals if they wanted to be on the preferred network service and benefit from the cashless system.
A joint statement signed by the National Insurance Company, New India Assurance, Oriental Insurance and United India Insurance Company, said: “The purpose of working out such package rates and stabilizing the hospitalization costs will benefit the insured in many ways. We along with some third party administrators (TPAs) worked out package rates for some of the hospitalization expenses, which are commonly claimed under our health insurance policies,” the statement said. TOI had published the new packages worked out by the TPAs in its edition dated July 10.
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