Is your hospital charging you irrationally? Check its rating.
Apr 21, 2014

Author: PersonalFN Content & Research Team

Impact

Serving a patient was once considered to be equivalent to serving God. But these days, with increasing commercialisation, the nobility of the medical profession seems to be on a decline. You visit a hospital for any treatment, more often, the first question you will be asked would be whether, do you have a health insurance policy and how much is your coverage under it, or you are going to pay from your own pocket. Now, if you have health insurance coverage, in all possibility, the hospital could charge you a different rate than what it would have charged you otherwise. Of course, there are exceptions. Not all hospitals are alike and there are still a number of hospitals and clinics which run on ethics. But, what is worrisome is, the number of hospitals following malpractices and billing their patients exorbitantly is growing. But to address to this issue, the Insurance Regulatory and Development Authority (IRDA) has now stepped in with an initiative which could help you identify hospitals offering you affordable treatments.

Here is how?
IRDA is planning to establish a system to rate hospitals. This will help track charges levied and procedures followed by hospitals. You see, it has been observed by the regulator that due to lack of availability of consolidated data on health insurance segment some hospitals have been charging their patients irrationally. Moreover, cost of a particular treatment differs significantly from hospital to hospital. Keeping a track of costs associated with treatments would make it easy for the regulator to identify abnormalities in the cost structures of medical treatments.

As suggested by IRDA, insurers would be asked to map every chain hospital with a unique identification code. The unique identification code assigned to a respective hospital will be integrated with the pin code of the area and name of hospitals, which will facilitate easy tracking.

Does rating system for hospitals serve the purpose?
At present there is no regulator for hospitals. However, PersonalFN believes that, once IRDA introduces a rating system based on data gathered from insurance companies, hospitals would become more cautious in dealing with patients and charging them appropriately for treatments. From the patient’s perspective, it would become easy for them to identify hospitals which offer them treatments at affordable rates. Moreover, insurance companies would find the rating system helpful in bringing down occurrence of inflated claim settlement. The rating system may also assist insurers in identifying fraudsters and blacklisting them.

PersonalFN is of the view that, introducing a rating system for hospitals would offer benefits to health insurance companies as well as buyers of health insurance policies. Insurance Information Bureau (IIB) has established a registry covering records of about 26,000 hospitals. Such a huge coverage would help track and monitor costs of various treatments across grades of hospitals and across states. Eventually, this may help a person identify hospitals where he / she could get the affordable treatment. Having said this, PersonalFN is also of the view that, proposed rating system wouldn’t give any guidance on quality of treatment provided by any hospital. For example, it would be wrong to conclude that, hospitals providing treatments at cheaper cost compromise on quality. At the same time, it would be equally wrong to say that, hospitals which charge you more may not be compromising on quality of treatment. However, as far as identifying a broader trend in cost of a particular treatment is concerned, the proposed rating system would definitely offer guidance.

PersonalFN is of the view that, every one of you must make sure that, one is insured with adequate cover. Those who are approaching retirement should revisit their health insurance portfolio. Unless you do that, you can never be sure that, at a later stage of your life you don’t have to shell out your hard earned money on medical treatments. Planning for retirement not only involves earning adequate sum to take care of your expenses, but it also means taking wise decisions to make your retired life peaceful and power it with financial freedom.

You see, PersonalFN is about to launch an exclusive retirement product for you. This product will guide and hand-hold you through the process of planning your retirement. It will walk you through everything that is required for a Rich Retirement. So stay logged on to www.personalfn.com to reap benefits.