The Heath Insurance industry is planning to launch cashless insurance in small nursing homes. This scheme will cover patients belonging to the large middle-income group who usually opt for small nursing homes for treatment. Earlier, people belonging to this particular income group were unable to avail cashless admission in small nursing homes even though they had medical insurance.

In a cashless scheme, the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the Third-Party Administrator (TPA) on behalf of the health insurer. This scheme is hassle-free and causes least discomfort.

In 2010, insurers had put a stop to cashless admission in most nursing homes across Mumbai after irregularities in medical bills became unbridled. The city and suburban nursing homes are in talks with insurance companies to restart the cashless admission services. For now, this proposal of reimbursement insurance scheme is for nursing homes in Mumbai only.    

“The talks have begun again with New India Assurance Co. Ltd. to position 150 nursing hospitals in Mumbai for the cashless service.”, said Dr Niranjan Agarwal, owner of Salasar Nursing Home in Bhayander. He further added that the insurance companies had problems with operations of small nursing homes because at that time, there were no standardized procedures for record keeping.  

Bhaskar Sharma, Managing Director at State Bank of India, informed The Indian Express, “There has to be an understanding of the pricing between insurance companies and small nursing homes. Nursing homes’ quality differs from one another which also need to be examined.”

Now, nursing homes have come together to form a voluntary accreditation body called the Forum for Enhancement of Quality in Healthcare (FEQH), on the lines of Quality Council of India (QCI), a central government accreditation board. This step is taken to introduce uniform standards for all network nursing homes.

“We started FEQH, which is QCI’s Mumbai chapter. It follows norms laid down by QCI and will also follow transparent packages for patients apart from maintaining uniform records and complying with basic healthcare norms,” Agarwal said. According to the health insurance experts, the cashless service will “definitely help middle class patients,” but warn against possible irregularities.

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