“In order to widen the scope of offering cashless facility across the country, insurance companies are now empowered to shortlist network providers who meet the standards and benchmark criteria specified by their respective boards. While specifying the criteria, the insurance companies The Board of IRDA, among others, will specifically consider the minimum manpower and healthcare infrastructure facilities,” said the IRDA circular issued on July 20, 2022.
Let’s take a look at what the new guidelines mean for health insurance policyholders.
How will this benefit the policyholders?
The insurance regulator has empowered insurers to shortlist network providers who meet the standards and benchmarks set by their respective boards. The circular also states that the board of insurance companies will, inter alia, consider minimum manpower and healthcare infrastructure facilities while defining the criteria.
Not only can you get quality healthcare with your health insurance policy, but you can also get cashless treatment at your preferred network hospital. “This essentially means that during hospitalisation, you can get cashless treatment – at your preferred network hospital – without paying anything to the hospital. This will help insurers to expand their network of cashless facilities
To enable the customers to avail the best medical facilities near them,” Sanjeev Bajaj, Joint. Chairman and Managing Director, Bajaj Capital.
Expanding the scope of the most sought-after feature of a health insurance policy will increase its attractiveness. “Cashless facility allows an insured to seek advice at any network hospital without having to worry about paying the bills himself. The insurer will directly settle the medical bills as per their policy,” says Amit Chhabra, Head of Health Insurance Business, Policybazaar.com.
Most policyholders primarily use the comprehensive . buy health insurance cover for cashless claim Facility. “When it comes to hospitalization, the cashless claim settlement process is the best option because of the convenience associated with it and you don’t have to travel to different places to make financial arrangements,” says Chhabra.
What was the earlier process?
Earlier the process of empanelment for cashless service in the hospital had multiple stages and was cumbersome and time consuming. “Earlier, hospitals wishing to be empaneled had to register in the Insurance Information Bureau’s Registry of Hospitals with Network of Insurers (ROHINI). They are awarded certain certifications such as “NABH Entry Level (or higher) certification issued by the National Accreditation Board (NABH) or State Level Certificate for Hospitals and Health Service Providers (NABH) under National Quality Assurance Standards (NOAS) issued by National Health System Resources”. There was also a need to get the Center (NHSRC),” says Bajaj.
However, the new guidelines are expected to increase the reach of health insurance, take health insurance to the masses and widen the scope of providing cashless services across the country. “This will increase access to comprehensive, high-quality health care services as insurers will be able to expand their network of hospitals where the insured can avail the facility of cashless treatment,” says Chhabra.