INDIA – The Insurance Regulatory and Development Authority of India (IRDAI) has allowed insurers to choose network providers or hospitals that meet standards and benchmarks as specified by their boards to boost cashless treatment in the country.
“In order to enhance the scope for offering cashless facility across the length and breadth of the country, the insurers are now empowered to empanel the network providers that meet the standards and benchmarks criteria as specified by their respective boards,” IRDAI said in a circular to insurers and third-party administrators (TPAs).
While empaneling network providers for cashless facilities, insurers have been advised to focus on delivery of quality healthcare services, IRDAI said in a statement.
The cashless feature allows an insured person to take advised treatment at any network hospital without worrying about paying bills by himself. The insurer will directly settle the medical bills as per their policy.
When it comes to hospitalization, a cashless claim settlement process is the best option because of its convenience, and you do not have to run to different places to make financial arrangements.
Amit Chhabra, Head – Health Insurance, Policybazaar.com said: “Further, this will increase access to comprehensive, high-quality health care services as the insurance companies will be able to expand their network of hospitals where the insured can avail the facility of cashless treatment.“
Earlier, only those network providers which were registered in the Hospital Registry ROHINI maintained by Insurance Information Bureau (IIB) could be empaneled by the insurers.
While empaneling network providers for cashless facilities, insurers have been advised to focus on delivery of quality healthcare services.
Hospitals offering cashless services had to also meet the pre-accreditation entry-level standards laid down by National Accreditation Board for Hospitals (NABH) or State Level Certificate under National Quality Assurance Standards, issued by National Health Systems Resources Center.
“The regulator is steadily improving the ease of doing business. This circular allows insurers to take independent decisions on which hospital to empanel and then be transparent about that,” said Kapil Mehta, co-founder, SecureNow.
IRDAI further said the boards of insurers should consider the minimum manpower and healthcare infrastructure facilities before empaneling a hospital.
The board-approved empanelment criteria should also be published on the website of the insurers from time to time, the circular said.
On the IRDAI’s decision, Sharad Mathur, MD and CEO, Universal Sompo General Insurance said the regulatory initiative would increase the scope of the insurers’ cashless services which would play a pivotal role in reducing the financial burden on policyholders.
“This will also provide a strong network of health care plus insurance services countrywide,” he said.
The regulator has also asked the insurers to focus on the delivery of quality healthcare services while taking on board hospitals for cashless facilities.
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