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Insurers' cashless norms to cover four more cities

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Hyderabad, Kolkata hospitals to come under network from April 1 "THE decrease in claims amount is the reason why we decided to extend it to four other metros" Segar Sampath Deputy general manager, New India Assurance Company

COME April 1, 2011 and health insurance policy holders in cities like Hyderabad and Kolkata will have to check if hospitals would continue to offer cashless facilities for treatment.

The preferred provider network (PPN) list of hospitals, which can offer cashless medical treatment, will be extended to four cities including Hyderabad, Kolkata, Ahmedabad and Chandigarh, from April 1, 2011, said Segar Sampath, deputy general manager, New India Assurance Company, to Financial Chronicle.

The PPN list of 449 hospitals was originally introduced in the four metros Delhi, Mumbai, Chennai and Bangalore, from July 1, 2010.
With the introduction of the scheme, only those hospitals in the PPN list would be able to offer cashless treatment facilities for health insurance policy holders.

Hospitals outside the list would not be able to offer cashless treatment and the policy holders would have to pay the hospital for treat ment and get it reimbursed later from their health insurance company.

The four public sector insurance firms -New India Assurance, General Insurance, United India Insurance and Oriental Insurance -came out with the PPN list after it was identified that private hospitals charged higher rates for those patients who had health insurance cover compared to those who did not possess one.

Over-billing by the hospitals resulted in the four public sector health insurers losing over Rs 2,000 crore, the minster of state for finance, Namo Narain Meena, had said in July last year.

"We have talked and negotiated with hospitals in these four cities and have arrived at the rates applicable for 46 different surgical procedures and the rates applicable for each of those," Sampath said.

"The introduction of the PPN list in Delhi, Mumbai, Chennai and Bangalore has been functioning quite effectively.

There has been a reduction in claims amount too.
That was the reason why we decided to extend it to four other metros," Sampath said.

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