Health Insurers to Create Common Platform to Identify Fraud

Health insurance providers in India are joining hands to create a common platform to enroll hospitals for cashless claims that will help them identify frauds. The platform is also expected to make the tie-up process easier and help bring down costs.

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      Increase in Cashless Claims

      The major objective for coming up with a common platform is to increase cashless claims from 55% to 100%. Moreover, it will also help to keep a check on any industry leakages due to fraud, abuse and waste by identifying bad players in the healthcare sector. While ethical players will be rewarded, the council plans to take strict action against hospitals found guilty.

      The nature of the action taken may differ on the intensity of the alert from the members, right from a warning to suspension from the health insurance network. So far, the council has identified about 30 hospitals against which it plans to take action.

      Besides, the common platform will also ease out the insurer tie-up process for the hospitals as, currently, they have to deal with 30 insurance companies separately. Doing so is not only inconvenient but also time-consuming.

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