Five out of 10 patients face delay in discharge due to time taken to process mediclaim: Study

Five out of 10 patients in India face delays in discharge due to the time taken to process medical insurance claims, according to the latest report by healthcare provider Pristyn Care. 

To alleviate the hassle experienced by health insurance policyholders, the Insurance Regulatory and Development Authority of India (IRDAI) is likely to introduce a 100 per cent cashless hospital network that will include both empanelled and non-empanelled hospitals, the company's press release said.

The study indicates that over 40 per cent of individuals attribute delays in health insurance claims in India to hospital administrative processes, while 25 per cent cite a lack of coordination between hospitals and insurance providers. 

Complex documentation procedures also significantly contribute to these delays.

The study also found that six out of 10 individuals never initiated the health insurance claim process. Among those who did, 34 per cent expressed dissatisfaction with the paperwork, while 40 per cent faced challenges in receiving timely responses from their insurance providers. 

Source: Press Release

According to a report by IRDAI, currently, cashless settlement services are accessible in 49 per cent of hospitals in India. Both general and health insurance companies update their roster of affiliated hospitals in response to costly medical bills and false claims aimed at increasing payouts from insurers.

To address these challenges, the insurance regulator, in collaboration with the General Insurance Council, aims to establish a nationwide common cashless hospital network, the press release added.

About Pristyn Care

Pristyn Care is one of the leading healthcare providers that performs advanced secondary care surgeries with the help of its 200+ in-house surgeons across hundreds of partner hospitals and clinics. The company was founded in August 2018 by Harsimarbir (Harsh) Singh, Dr Vaibhav Kapoor, and Dr Garima Sawhney.