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#Medicalnsurance thread.
About 2 decades back very few pts had medical insurance cover. Those who had used to pay hospital upfront & then claim reimbursement.
A change started ~ 2 decades back when third party administrator (TPA) started coming into picture as the mediators.
About 2 decades back very few pts had medical insurance cover. Those who had used to pay hospital upfront & then claim reimbursement.
A change started ~ 2 decades back when third party administrator (TPA) started coming into picture as the mediators.
The TPA's acted as agents between the patient, hospital & insurance companies. Hospitals signed "cashless" agreement with them to provide services to pts. The estimate would be evaluated & cleared by TPA. Denial of cashless treatment is not denial of insurance. TPA's proliferated
Insurance companies wanted to control cost of treatment at hospital. As their customer base increased, they had more power to negotiate. Govt insurance companies which had ~ > 70 % Mediclaim business,made a cartel called #GIPSA which made low cost package for many procedures.
