The private sector hospitals and PSU insurers are likely to arrive at an interim settlement on restoration of cashless treatment facility at major hospitals in the country from tomorrow.
The major corporate hospitals - Apollo Healthcare, Max, Medicity and Fortis- have given their package rates for treatment under mediclaim policies to the Third Party Administrators (TPAs), which are the facilitators between the insured and the insurer.
Final rate structure would be decided in another 30-40 days. Under the structure that is being worked out, hospitals would be categorised on the basis of super specialty medical centres and premiums would vary accordingly.
Currently there are 449 hospitals across the country under the cashless network, but corporate hospitals were removed by the PSU insurers from their preferred provider network (PPN) from July 1.
Four insurance companies - New India Assurance, United India Insurance, National Insurance and Oriental Insurance - had stopped the cashless service to these hospitals on charges of over-billing.
Currently many health insurers give more in claims than they collect from premiums. In fact, the claim ratio, which measures this trend, is about 140 per cent for the industry.
The public sector insurance companies had to resort to rationalisation of rates for cashless facilities as they suffered a loss of Rs 2,000 cr because of overcharging by hospitals in Mumbai, Delhi, Chennai and Bangalore.
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