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In the direction of forming health insurance and information grid, Insurance Information Bureau (IIB) and Insurance Regulatory and Development Authority (IRDA) are willing to involve insurance companies, third-party administrators (TPAs) and hospitals. Delighted with the reform, insurers see a better future of health insurance industry where they can identify the loopholes.
Creation of unique identity number for hospitals is the first step taken by IIB in this direction and now insurers can concentrate only on the registered hospitals as there are many hospitals with the same name. This initiative will generate transparency and health insurance charges can be capped, as quoted by the chief executive of a private general insurance firm. He also informed that the renewal of agreement between insurer and hospitals will be dependent on the unique identity number provided by IIB.
As T S Vijayan, IRDA chairman reported, this system is likely to help insurers identify the registered hospitals and create a data centre scattering information of the charges for various procedures. He added that the unique number will be incorporated with the name of hospital and the pin code of the area. IRDA is collecting transactional data from various insurers which can help them to compare the charges offered by various hospitals.
IIB is collecting health insurance data from all the transactions done with insurers, hospitals and TPAs to work on its analytics and data upgradation process form insurance sector.
Sanjay Datta, head of underwriting and claims said that health insurance grid will be acting like an imperative connector regarding health insurance data exchange between insurer, insured and health service provider.
Officials of IIB informed that targeting 380,000 hospitals, they are done with 30,000 hospitals and the identification is done on the basis of title, address and pin code.
CEO of IIB, R.Raghvan said that with this reform, insurers can have a uniform list of hospitals and charges claimed for different procedures. Any new hospital joining the system will be added to this list. This way, health insurance industry can keep a keen eye on the claim system and work with the transparency in terms of cost and chucking out discrepancies.
General Manager of a public general insurer reported that even for patient under health insurance policy, various hospitals charge different rates which can be tracked through health insurance grid. Such misconduct when noticed by the regulatory body can offer reduced cost for insurers and customers.