To prevent over-billing by hospitals, the insurance regulator is working on a system to capture data with regard to health insurance systems and entire medical process and billing claims, according to media reports.
The system will be aimed at improving health insurance services. Apart from reducing the cost of health insurance, the system would also be useful in developing a code in line with the global practice in future, the reports added.
Due to high cost to claim ratio, the health insurance business in India is suffering losses. The cost ratio for the public insurers was 140% of the premium received under the health portfolio in June 2012. The four public insurers–National Insurance, New India Assurance, Oriental Insurance and United India Assurance–had in July 2011 stopped the cashless facility in select private hospitals due to over-billing.
The insurers said that some hospitals were charging the patients having health insurance policies at rates which are quite higher than the reasonable cost of treatment, the reports concluded.
