In 2014, Preferred Provider Organisation (PPO) is anticipated to have eminence with large number of hospitals coming in this sector. PPO is basically a health arrangement which provides the right of selecting the doctor and hospital to the participant. Better number of hospital tie-up is expected to occur with the introduction of unique identity numbers for hospitals by Insurance Regulatory and Development Authority (IRDA) and Insurance Information Bureau (IIB).
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The increasing health insurance claim expenses have offered escalating losses which has become a concern for many. In order to downsize health cost via PPO, public general insurers have come up with a mechanism where, an insured can have cashless treatment in the hospitals which have agreed to the preferential pricing.
During emergency, an individual can even select the hospital which is not in the list of PPO and the reimbursement of the charges will be done under the policy.
A senior official highlighted the importance of unique number system by IIB as now they are likely to receive ample data related to hospitals subsequently many of them would not get registered under PPO.
The consistent rates displayed by PPO are not sounding reasonable for many hospitals and hence they don’t wish to be a part of PPO. But insurers have a brighter hope of these hospitals joining PPO as they expect to have a clear data of the extra charges paid for each medical procedure.
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