HEALTHCARE & HEALTH FINANCING AN OVERVIEW

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RESPONSE OF HOSPITALS


Licensing
Certification
Accreditation
Rating
Standardization

PROBLEMS FROM INSURERS

Policy condition problems
Customer Ignorance
Pre-Existing Condition Issues
Disputes with hospitals / insured
Delays


PROBLEMS FROM TPAs

Lack of Infrastructure
“There are no holidays in Health care” yet
offices not open on holidays, telephone access unavailable, etc
No qualified doctor / staff
Delay in settlement
Deduction in bills without basis
Increased paperwork


A BILLION LIVES TO COVER

Focus on rural / micro insurance
Dialogue between Providers, Insurers, TPAs.
Increase in numbers & premiums
Working with Government