Except Apollo group, cashless health cover services have been restored in all other corporate hospitals, after their managements agreed to the standard treatment rates negotiated by the public sector health insurance providers.

The rates fixed by New India Assurance, Oriental Insurance, United India Insurance and National Insurance after long discussions have been agreed to by the corporate chains, said G Srinivasan, chairman and managing director, United India Insurance. He did not specify the discount in rates offered by the hospitals to the insurance firms.

Speaking at the Federation of Indian Chambers of Commerce and Industry, he said health policy holders can also get treatment from those (including Apollo) not in their (insurance firms’) preferred providers network (PPN), though the policy holder have to clear the bills & later claim for reimbursement.

The PSU insurance firms had removed the names of hospital chains such as Fortis, Max and Apollo from their PPN list after a difference of opinion on rates. The insurance firms said they were losing money due to high claims and the big chains felt the rates sought by the former weren’t enough.

A deal was finally struck after the insurance companies brought the larger healthcare providers under a special category, A+, with a differential price tag, for their services. PSU insurance firms now classify healthcare providers as A, B, C, D and A+.

Following the footsteps of their big cousins, organisations representing small scale healthcare establishments are also asking PSU health insurance firms for a rate revision. Srinivasan said such a revision is always a possibility, but the current rates would continue for some time.

Private players are yet to have a dominant share in the health insurance business.

 

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