No more cashless facilities: Hospitals in Ahmedabad boycott three insurers

Ahmedabad: The member hospitals of the Ahmedabad Hospitals and Nursing Homes Association (AHNA) stopped cashless facilities for three insurance firms from April 2.

The association put forth issues affecting treatment and claimed the support of the Indian Medical Association (IMA) Gujarat, Ahmedabad Medical Association (AMA), and organisations of ENT surgeons, orthopaedic doctors, and gynaecologists, among others, in addition to state organisations from Rajasthan, Uttar Pradesh, Madhya Pradesh, and Punjab.

Dr Bharat Gadhvi, president of AHNA, said that several hospitals were delisted without due and just process and without information to several of these hospitals. Another major issue was the non-revision of charges for many years and the tendency of the firms to disown authorisation letters issued by them for cashless treatment. "It often leads to skirmishes between hospitals and patients," he said.

AHNA members pointed out that the issues delay the discharge of the patients, flouting guidelines issued by IRDA. "At the time of settlement, unnecessary and irrelevant raising of queries by non-medical personnel appointed by insurance companies, rejecting claims of the patients by raising irrelevant issues are also raised by patients time and again," said Dr Viren Shah, vice-president of AHNA.

AHNA members asked the firms to take decisions on the exclusion of hospitals, revision of charges and redressal of issues about claims to ensure seamless service to patients.

Some of the insurance firms termed the claims "unsubstantiated, misleading, and factually incorrect", whereas another statement alleged that the association did not engage with them for resolution.