homehealthcare NewsDiscussions with Ahmedabad hospitals have reached an amicable solution, says Star Health
Discussions with Ahmedabad hospitals have reached an amicable solution, says Star Health
The clash between insurers and hospitals in Ahmedabad over treatment costs and pending dues is once again in the spotlight, underscoring the complex dynamics of the healthcare industry. With the October 15 deadline approaching, all eyes are on the negotiations between the Ahmedabad Hospitals and Nursing Homes Association and Star Health and Allied Insurance. The resolution of this dispute will likely have a lasting impact on healthcare practices and policies in the region, as both parties strive to strike a balance between financial sustainability and the provision of quality healthcare services to the people of Ahmedabad.
In the vibrant city of Ahmedabad, a new battlefront has emerged in the ongoing tussle between healthcare insurers and hospitals. While the healthcare industry experienced a temporary respite from their confrontations in the wake of the COVID-19 pandemic, the issues have now resurfaced with renewed vigor. At the center of this dispute is the Ahmedabad Hospitals and Nursing Homes Association (AHNA), which has issued a stern ultimatum to the standalone health insurer, Star Health and Allied Insurance, threatening to withdraw the cashless facility unless a series of concerns are urgently addressed.
Nilesh Kambli, the Chief Financial Officer of Star Health & Allied Insurance, has affirmed the insurer's dedication to achieving a harmonious resolution to this standoff. “We have already done discussions with the hospital associations, we have reached an amicable solution. We should continue with our relationship with hospitals,” he said.
In a conversation with CNBC-TV18, he emphasised the company's unwavering commitment to safeguarding the interests of its valued customers. Kambli also expressed optimism that the matter would be effectively addressed during a forthcoming second round of discussions scheduled for October.
“There will be a second dialogue, which will happen in the first week of October and the issue will be resolved,” he mentioned.
Out of the approximately 15,000 hospitals associated with the insurer, a concerning 500 have faced suspension. Star Health & Allied Insurance claims that it has been forced to discontinue relationships with 500 hospitals over the past two years due to non-compliance with medical protocols and cases of fraud.
“In the last two years, we have suspended more than 500 hospitals. We have reached solutions with some of them but if they are not adhering to the conditions that we enforce, almost more than 500 hospitals we have discontinued in the last two years,” he said.
“Not adhering to the tariff rates, excess use of antibiotics, certain lab testing which are not required, the doctor visits excessive billing, if we see some misrepresentation, frauds also from some of the hospitals are multiple reasons due to which we take this action,” he explained.
The AHNA, representing a coalition of hospitals and nursing homes in Ahmedabad, has set a firm deadline of October 15 for Star Health and Allied Insurance to rectify several critical issues that have sparked this dispute. These issues include the alarming rate of claim rejections after initial approvals, prolonged delays in clearing payment dues, exorbitant charges fixed by the insurance companies, which the hospitals label as 'unsustainable,' and the removal of hospitals from the insurer's networks.
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