Tell hospitals about cleared claims in 1 hour: Irdai
New Delhi, Apr 30: Insurers have been told to communicate their cashless approvals for COVID-19 claims within an hour of submission of the request by the hospital, the Insurance Regulator and Development Authority said.
The Delhi High Court had on April 28 told the Irdai to issue immediate instructions to insurance companies to ensure that they communicate their approvals to hospitals within30-60 minutes in order to ensure that the discharge of a patient is not delayed.
"Decision on authorisation for cashless treatment for Covid-19 claims shall be communicated to the network provider (hospital) within a period of 60 minutes from the time of receipt of authorisation request along with all necessary requirements from the hospital," a circular from the Irdai said.
"Decision on final discharge of patients covered in Covid-19 claims shall be communicated to the network provider within a period of one hour from the time of receipt of the final bill along with all necessary requirements from the hospital," the circular also said.
There have been multiple reports of patients being denied cashless services by hospitals despite having proper insurance covers. The Irdai has told policy holders to inform their insurance companies promptly about such anomalies. It also said that the insurers can lodge complains about hospitals which are errant with the respective state governments.