Big Blow to Customers – Cashless Treatment Stopped at Max Hospital After Insurance Dispute

New Delhi (The Uttam Hindu): There is bad news for lakhs of policyholders who avail cashless treatment through health insurance at Max Hospital, one of the leading hospitals in the country. Major insurance companies like Niva Bupa, Star Health and Care Health have discontinued their cashless facility in all branches of Max Hospital across India with immediate effect.

This decision means that patients holding policies of these companies will now have to bear the entire cost of treatment themselves when admitted to Max Hospital. Later, they can claim reimbursement of the amount spent by submitting the necessary bills and documents to their insurance company. Insurance companies have clarified that documents like discharge summary, all medical reports, doctor's prescription, bills, Aadhaar card, PAN card and a cancelled cheque will be required for reimbursement.

The development is a result of growing tension between insurers and hospitals over treatment rates. Just a few days ago, the Association of Healthcare Providers India (AHPI), which comprises over 20,000 hospitals in the country, including Max and Fortis, had directed all its member hospitals to discontinue cashless facility for Bajaj Allianz General Insurance customers from September 1.

AHPI has also sent a similar notice to Care Health Insurance and has asked for a reply by August 31. If a response is not received, the cashless facility will be discontinued for Care Health policyholders as well.

According to Dr. Girdhar Gyani, Director General of AHPI, an organization of hospitals, medical expenses in India are increasing at the rate of 7-8% every year, which includes salaries of employees, medicines, equipment and other expenses. He alleges that insurance companies like Bajaj Allianz have long been rejecting the demand to revise treatment rates with time and are instead pressuring to reduce the rates. Apart from this, hospitals are also angry with the delay in claim settlement and discharge approval to patients. AHPI says that providing treatment at the old rates is no longer possible and this may affect the quality of care of patients.