When most people in India take medical insurance, they do this hope that they will get a chewle treatment when they entered the hospital. That is, they will not have to pay out of pockets, but the insurance company will pay directly to the hospital. But recently have a major dispute with this casteful facility between hospitals and insurance companies.
The controversy is at disagreement between hospital and insurance companies, but it is direct on patients. If this controversy does not solve, millions of people may face difficulty for treatment.
The story is that the Association of Healthcare provider of India (AHPI) accused the insurance companies refused to accept the growing cost of treatment. AHPI is an organization of several hospitals across the country. It is to believe hospitals have increased significantly after covid -19. The price of everything has increased from medications, infrastructure and machines. In such a situation, hospitals is not possible to work on ancient rates. They want insurance companies that increase rates for treatment, but insurance companies are saying it and do not want to increase rates.
Declaration not to give unchecked facilities from September 1 & MLDR;
On August 22, AHPI declared that he would not provide culpral treatment facilities to customers like Bajaj Alanz and Care Health Insurance, such as Bajaj Alanz and Care Health Insurance. Now only 2 days left for this date. This means that the customers of these companies will have to pay for money before they enter the hospital. This could have troubled millions of policies.
Talks between Bajaj Alanz and AHPI. In him, AHPI said that if the company restores the savage to some hospitals immediately, he could reconsider their decision to close the cashless facility. The matter is not yet complete, but the situation is sensitive.
Insurance companies say that the hospital is increasing the rates of the treatment of a solid ground without a concrete basis. We can accept that the expenses have increased, but to double the rates at the same time or three times the same time. He says the talks should be done on the hospitalization, not everyone is imposed on the hospital.
Hospitals have their own problems & mldr;
On this, the hospital organization AHPI says that insurance companies are not only refuse to accept new rates, but sometimes delay the bills and the premature approval) and take place in the premises. For all these reasons, the functioning of the hospitals have become difficult.
Decision not in the interest of the patients: insurance companies & mldr;
An organization working by insurance companies criticized the Ahpi’s decision and said it was against patients. He says that by blaming the casteful facility in suddenly can rise confidence from the people’s health insurance system and the common policyholders will have a direct loss.
If the patient does not find cashless treatment, what should he do
The question now is if a patient does not have a chewing facility for a patient, what should he do? Let you know that there is an option of claim in such a situation. This means that the patient or his family will first pay the full cost of the treatment and later will give all the bills and the necessary documentation. After checking these documents, the company spent the amount of money returned to the patient’s bank account. Usually this process is completed within 15 days.
But it is only possible when the treatment is involved in your policy and the hospital you entered in the company. Sometimes insurance companies also check the bills so that there is no incorrect or exaggerated claim.
If the treatment is planned, do it first & mldr;
If the treatment is planned (ie it is already decided), the best way is to inform your insurance company in advance. They will tell you which documents will be needed. Some companies now pass the claim only by viewing discharge summary and the digital copy of the bill.
It is important for patients carefully reading your policy. It clearly states what diseases and treatment is involved in and what is excluded. In most cases, there is a 30-day period limit to file a claim after the hospital. In case of emergency enrollment, the company must be notified within 24 hours.
If the insurance company ever cancels your claim, you should first ask the reason for the company. If the problem is still not the solution, you can enter your complaint in the Lokpal or Consumer Court.