Health insurers to decide on cashless authorisation within one hour: Regulator

This decision is poised to greatly enhance the efficiency and consumer satisfaction levels within the health insurance sector.

Health insurers to decide on cashless authorisation within one hour: Regulator- In a landmark move aimed at streamlining the health insurance process, the insurance regulator has mandated that insurers must decide on cashless authorization within one hour. This decision is poised to greatly enhance the efficiency and consumer satisfaction levels within the health insurance sector.

Historically, the process of approving cashless claims has been time-consuming and often fraught with delays. Policyholders frequently faced extended waiting periods, which could span several hours or even days, before receiving confirmation on whether their cashless treatment requests would be approved. This delay has been a significant source of stress for patients and their families during medical emergencies when immediate access to funds is critical.

According to the new directive issued by the regulator, the one-hour timeline is non-negotiable. And begins from the moment the insurer receives the cashless request from the hospital. Insurers are now required to implement systems and processes that ensure rapid evaluation and decision-making regarding these requests. This modernization is expected to significantly reduce the financial burden on policyholders during times of medical emergencies. As they will no longer need to arrange for funds upfront while awaiting approval.

Industry Reactions

Stakeholders in the health insurance industry have welcomed the regulator’s directive. Insurers acknowledge that the one-hour rule would necessitate substantial improvements in their current systems. Including better synchronization with hospitals, more robust IT infrastructure. And perhaps even the use of artificial intelligence for quicker claim assessments. However, many see this as a much-needed step towards improving transparency and bolstering the trust of policyholders.

Hospitals are also expected to benefit, as quicker cashless authorizations will streamline their billing processes. Reduce administrative overhead, and improve patient turnover rates.

Overall, this new mandate holds the promise of transforming the health insurance landscape. It embodies a proactive approach to crisis management. Ensuring patients receive timely medical care without the added anxiety of financial hurdles.

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