Hospitals overcharge patients with medical cover ……..Manthan K Mehta
Mumbai: Public insurance companies have drastically pruned the list of hospitals they used to service. There were over 800 hospitals providing cashless benefits to patients insured by public health insurance companies in Mumbai, said Dr Mohammed Mukhtar, health strategist and manager, MD India Health Care Services. Most hospitals were inflating bills they submitted to insurance companies. Apart from blacklisted hospitals, the insurance firms decided to exclude hospitals which dont have adequate infrastructure from the Preferred Provider Network (PPN).
A total of 90 hospitals across Mumbai and Thane have been chosen under the new PPN where patients can get cashless insurance. Companies have also finalised a rate card to curb fraudulent methods. Investigations revealed some hospitals charged ridiculously high sums for visits made by doctors and specialists, said Dr Mukhtar. They also levied exorbitant rates for articles or items used during treatment. In same cases, patients were billed for treatment of non-existing ailments or unnecessary hospitalisation was shown.
Some hospitals also opted out of the PPN because of stringent norms. An official from a rival TPA firm said, Fixing uniform rates in a city like Mumbai is not practical, as cost of treatment varies due to disparity in real estate prices, infrastructure experience and expertise of medical professionals.
Shirish Deshpande of Mumbai Grahak Panchayat said, There are fears that hospitals may compromise on the quality of treatment.
M Ramadoss, CMD, New India Assurance Company Ltd, was unavailable for comment.