The Association of Healthcare Providers – India (AHPI) has urged health insurance companies to restore cashless hospitalization services to policyholders. Thousands of policyholders in India are currently without access to cashless hospitalization due to disputes between hospitals and insurance companies. AHPI Director General Dr. Girdhar Gyani stated that the association has asked insurance companies to revoke the suspension of cashless services at hospitals that were removed from their panel.
The issue began when Niva Bupa Health Insurance suspended cashless treatment facilities at Max Hospitals across India due to a disagreement over premium revisions. Similarly, AHPI had advised its member hospitals in North India to stop providing cashless treatment facilities for policyholders of Bajaj Allianz General Insurance Company. However, the suspension was later revoked after the company addressed the concerns and removed the embargo on some of the hospitals.
Dr. Gyani explained that the root cause of the issue is the need for sustainability in the healthcare sector. While the government and the public want affordable healthcare, insurance companies and hospitals need to ensure that their services are sustainable. He suggested that insurance companies can improve their operating efficiency by reducing administrative costs, commissions, and sales expenses, which currently account for 30-35% of the premium collected.
Dr. Gyani also emphasized that hospitals must improve their operational efficiency and cut down on expenses to make healthcare more affordable. Ultimately, the goal is to create a sustainable model that provides affordable healthcare to policyholders while ensuring that hospitals and insurance companies can operate efficiently. The AHPI is facilitating conversations between hospitals and insurance companies to address the issue and provide respite to patients.
In a statement, Care Health Insurance assured that it is providing cashless services to its policyholders and is working closely with partner hospitals to ensure seamless services. The AHPI has sent notices to seven insurance companies, including Niva Bupa Health Insurance, asking them to revoke the suspension of cashless services at hospitals. The association is working to resolve the issue and create a sustainable model that benefits all stakeholders. By improving operational efficiency and reducing costs, insurance companies and hospitals can work together to provide affordable and sustainable healthcare services to policyholders.