Hospitals in Nagpur refusing cashless facility for Covid patients

Friday April 9, 2021 at 10:09 am
Nagpur: Hospitals have started refusing cashless facilities for patients suffering from Covid. Such a trend was noticed during the first wave of Coronavirus.
A mediclaim consultant stated that with the increase in the number of active cases, there has been a shortage in the number of beds and the private hospitals are stressing on cash payment. The hospitals are blaming it on third-party administrators (TPAs) and insurance companies for delaying the payments during such critical hours and also for the insurer’s arbitrary deductions in the bills.
During discharge or death, it takes almost 6-7 hours to approve under the cashless scheme. Thus, such a delay holds back the whole process including delay in providing bed to the next patient, according to a source from the hospital. The TPA officials ensured that their approvals were granted in no time.
Insurance company sources are blaming the hospitals. Insurers stated, “Hospitals are overcharging and under the cashless scheme only justifiable expenses are cleared. Under cash mode, the onus is on the patient to submit a claim with the insurance company and get a reimbursement. This makes it convenient for the hospitals”.
Prasanna Dani, a health insurance consultant opined the hospitals are stressing on cash payments in advance. He also said, “There have been instances of insurance companies disallowing sizeable amounts from the bills submitted by hospitals at the time of cashless settlement”.
Rahul Khasnis, another insurance consultant told that hospitals are stressing on cash payment for beds over and above the quota reserved for the patients suffering from Covid. He further added, “As per norms, hospitals have set aside part of the beds exclusively for Covid patients. If any additional patient has to be taken in, cash payment is being insisted on”.
Dr Anup Marar, convener of Vidarbha Hospitals Association (VHA) opined that the insurance companies’ delay is resulting in the loss of crucial working hours for the pre-burdened hospital machinery. He stated, “During this period there are jittery patients waiting to get discharged and others waiting to get admitted”.
Marar is of the view that based on the government supply rates, the insurance companies have decided their own price of remdesivir drug to the “bare minimum level. He said that no additional claim is being allowed.
He stated, “Hospitals, on the other hand, are purchasing whatever brand is being made available by the Food and Drug Administration (FDA). In such cases relatives are unwilling to pay the difference amount. Relatives of patients availing cashless scheme are being asked to procure the drug on their own too”.
Marar showed a document where a private insurer deducted Rs 16,000 from Rs 35,000 claim fro remdesvir administered to a patient.
Shahid Sharif, a consumer activist exclaimed that he had witnessed many cases where the hospitals are insisting on cash payment in advance.