The argument between third party administrator health insurance — using a third party to process credentials between hospitals and insurance companies — and the health sector seems to have taken a revolve for the inferior. Terming the new prices arbitrary, most doctors operation various hospitals and nursing homes in the Capital claim they were not concerned at any phase while setting up cost of treatment and grading of hospitals.
The director, Centre For Sight, and secretary, Intraocular Implant and Refractive Society, India  Dr Mahipal Singh Sachdev said, “Such unreasonable cutting down of expenses is ultimately only going away to make people suffer, as it would mean cutting down on the excellence of treatment”.
Dr Sachdev performs 500 cataract surgeries each month, which according to him has the second major insurance claim subsequent to cardiac procedures. “A lens can cost anyplace between Rs 500 and 1 lakh…. He said, we don’t wish for circumstances where we will not be capable to offer superior class lenses because we have to robust in the surgery in a particular budget.
The Delhi Medical Association also alleges that the prices were set without any discussion from its members. The president of DMA Dr Narender Saini said,” It’s a step clearly taken to benefit ‘A’ category hospitals. Prices of some events for the ‘C’ class hospitals are still lower than 50 per cent of what’s set for ‘A’ class hospitals. It’s unfair for people with small insurance coat, as for them; leaving to an ‘A’ class hospital would mean exhausting the whole insurance money in one go”.
The chairman of DMA’s nursing forum Dr V.K. Monga said, “We offer quality service to people at their door step, so we should be given first choice. How do they wait for us to survive the competition?”
Since July 1, public insurance companies had uninvolved a large chunk of personal hospitals form the directory of cashless treatment.
“There was no effort made to keep any one out. All were invited to contribute; some joined us, some didn’t. It’s unjust to say chance wasn’t provided. Prices, anyway, have been still left for negotiation,” said Dr Parvez Ahmad, CEO of Max Healthcare, who led the job force beside with Pavan Bhalla, CEO of Raksha, Third Party superintendent, to examine and come up with possible ways to contain action cost.