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Cashless mediclaim will now be offered at most hospitals

Cashless Mediclaim facilities which were put on hold by PSU companies in July last year is now gaining momentum. Close to 560 hospitals in Mumbai, Delhi, Bangalore and Chennai have been added to the preferred provider network (PPN).

Preferred provider network is a network of different hospitals that offer cashless mediclaim facility to policyholders. This is decided by an agreement between the third party administrators and the hospitals.

New India Assurance, National Insurance, United India Assurance and Oriental Insurance had stopped the cashless facility in select private hospitals as they felt that these hospitals over-billed customers who had insurance policies.  

The finance minister, Pranab Mukherjee said that in an effort to minimize inconvenience to policyholders, TPAs have been advised that for emergency cases, cashless facility should be provided in non-networked hospitals as well. He also added that PPN will be extended to Chandigarh, Kolkata, Ahmedabad and Hyderabad.

The TPA keeps updating the list of networked hospitals. In January, the IRDA strictly directed all health insurance providers to update their systems with details of network hospitals and servicing TPAs at the time of policy issuance or renewal. Insurance companies have been advised to inform their policyholders about their service providers and network hospitals at all times.

A senior insurance company official said that by the end of this financial year, all the major hospitals in Mumbai will join the PPN.

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