Mumbai, March 11 (NationPress) In light of the increasing grievances regarding the challenges faced in securing health insurance claims and the high medical bills charged by private healthcare facilities, Maharashtra's Minister for Public Health and Family Welfare, Prakash Abitkar, mandated on Wednesday that both health insurers and hospitals must prioritize the patient experience in their service delivery.

During a discussion with the Insurance Regulatory and Development Authority of India (IRDAI), along with major private insurance providers and prominent private hospitals, he stated that despite the professional nature of these entities, the welfare of patients should remain paramount. The meeting aimed to facilitate a collaborative approach among IRDAI, the Health Department, and service providers to enhance patient care.

With the consistent rise in health insurance enrollees, the Minister emphasized the crucial need for satisfactory service delivery as an essential duty.

“The government will not hesitate to enforce strict measures if any discrepancies are detected in the claim processes or hospital billing. Given the advanced healthcare infrastructure and skilled medical practitioners in cities like Mumbai, Pune, and Nagpur, there is significant potential for medical tourism. This potential can only be harnessed through improved credibility via superior service. All healthcare facilities across the state are required to register on the IRDAI portal and ensure their information remains current,” he remarked.

The Minister highlighted the necessity for a clear timeline for claim approvals to mitigate the mental and financial strain on patients stemming from disorganization between hospitals and insurers. Currently, approximately 7,000 to 8,000 hospitals in the state provide insurance-related services. Following reports of misconduct, he instructed authorities to enforce regulations under the Bombay Nursing Home Registration Act.

“Larger hospitals will be mandated to publicly display fixed price lists for various treatments. To tackle the issue of inconsistent pricing for identical treatments at different facilities, the government is considering standardized treatment protocols. Additionally, a unified empanelment system for both insurance companies and hospitals is being explored,” he stated.

The Health Department has called for consistent data on claims that are approved, denied, or pending. Notably, Maharashtra is poised to become the first state in India to actively gather and evaluate Maharashtra-specific complaint data from IRDAI for implementing necessary adjustments, the Minister added.

“Enhancing the credibility of the medical profession is the government's priority. We are dedicated to ensuring that patients do not encounter any obstacles in accessing treatment or settling their insurance claims,” he concluded.