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Hospital Insurance, PSU, Governmental and Corporate Tie ups

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Hospital Insurance, PSU, Governmental and Corporate Tie ups.

Hospital sector is now largely moving towards health insurance or health coverage in various formats. The ABPMJAY is the largest scheme that offers health coverage to around 40% of Indian population and further it plans to extend its coverage to more and more percentage of population. The central government schemes, Ex. Army man scheme, ESIC and no. of private and government insurances form the major part of health coverage. The large corporate houses, governmental and nongovernmental bodies also contribute to the health coverage schemes. There are different criteria for tie ups with these bodies. Some tie up on their own defined service rates while some tie up on the hospital tariff. All of them have a specific requirements of quality standards, documentation process, compliances, billing formats and have different clearance cycles. Hospitals require a clear understanding of these regulations and needful training and awareness of hospital staff has to be done in terms of compliance to their rules. Currently in India there is still major out of pocket expenditure for health care and government aims to reduce it fast. The standardization of regulations is need of the hour and merger of above schemes holds the key. The inclusion criteria are also refined periodically so as to provide coverage for more and more medical conditions. Telemedicine is the latest addition to these criteria.