Are Small and Medium Hospitals in Pune stopping cashless Insurance Facility?

The ‘cashless’ facility in some major hospitals in the city is on the verge of closure in the new year due to the dispute between the hospital administration and the insurance companies over the revised tariff. As a result, patients are likely to face immense hardships in getting treatment even with health insurance.

Discussions with the insurance companies regarding the revised tariff have been ongoing for the last three months. A big hospital in Pune has put up a notice board for the patients that the ‘cashless’ facility is being closed with immediate effect from Monday as the revised new 

tariff is not approved by December 31. 

The number of large private hospitals has increased in the city of Pune in the last few years. However, hospitals are facing many difficulties while providing ‘cashless’ facilities. Therefore, medical organizations say that the number of hospitals providing ‘cashless’ facilities in the city is decreasing.

There are four public and several private insurance companies offering mediclaim facilities with multiple packages. Small and medium-sized hospitals in Pune express deep concerns regarding the new empanelment and renewal processes initiated by insurance companies.

The ongoing negotiations between hospitals and insurance firms have significantly reduced the availability of cashless facilities, leaving numerous patients without access to cashless treatments. 

A few years ago, an average of 350 hospitals in the city had ‘cashless’ facilities. At present this number is running in 80 to 100 hospitals. As this facility is not available in small and medium hospitals, patients have to go to large private hospitals. It is seen that there is stress on big hospitals. The Hospital Board of India has corresponded with the insurance regulator in this regard. It has been demanded to provide a 100 per cent ‘cashless’ facility in all hospitals. 

“Oppressive conditions are reducing the number of ‘cashless’ hospitals. This facility should be available in all types of hospitals as the patient decides to seek treatment in which hospitals. As there are complaints of delay in getting the money to the hospitals, there should be a way out of it,” said a member of hospital board of India, Pune.

“Cashless facility is an agreement between the hospital and the insurance company to provide facilities is not quick. Rates are reduced when facilities are available; Also the cost of materials required for surgery is often not approved. It is necessary to solve the problems in ‘cashless’ facilities urgently for the benefit of the patients,” said a doctor from Pune.

“There are certain rules for starting a ‘Cashless in Hospital’ facility. Hospitals need all kinds of facilities and expert doctors to start the facility. Information is being sought whether the hospitals are facing any difficulties while providing cashless facilities,” said president of hospital association, Pune.

Details of City Hospitals:

• Total Hospitals: 780 
• Cashless Facilities: 80 to 100 
• Total Beds: 18,900 
• ICU Beds: 2 to 3 thousand 
• Ventilator Beds: 750 to 800