Even as public sector health insurance firms have reached an agreement with leading hospital chains to restore cashless mediclaim facilities to patients, thousands of nursing homes across the country are crying foul over the conditions laid down by the insurers.
The nursing homes, grouped under the banner of the Association of Medical Consultants, say they will not entertain insurance claims until public sector insurance firms agree to their demands.
The tug of war between the small hospitals and the PSU insurance firms has resulted in nursing homes offering special discounts to patients who pay out of their pocket for treatment.
“The problems faced by the big players are almost over as they are satisfied with the payment package offered by the insurance firms. However, at least 8,000 nursing homes are now opposing these terms and conditions thereby putting patients under trouble,” A Vaidheesh, chairman of healthcare forum, Ficci, and managing director, Johnson & Johnson (Medical) India, said.
According to Vaidheesh, who has been mediating between insurance companies and the hospitals to solve the cashless mediclaim issue, the small hospitals find package rates offered by insurance companies too low.
The four PSUs — New India Assurance, Oriental Insurance, United India Insurance and National Insurance Company — account for over half the country’s medical insurance market.
The nursing homes have no problems with the private health insurance players who continue to offer cashless services to their clients.
“Most of these nursing homes that have boycotted insurance firms are in Maharashtra. But a national movement is growing and hospitals in Gujarat have also approached me with the same compliant.” Vaidheesh said.