{"id":12910,"date":"2020-08-28T10:46:16","date_gmt":"2020-08-28T10:46:16","guid":{"rendered":"https:\/\/securenow.in\/blog\/?p=12910"},"modified":"2023-01-26T17:47:54","modified_gmt":"2023-01-26T17:47:54","slug":"max-healthcare-hospitals-de-empanel-max-bupa-health-insurance","status":"publish","type":"post","link":"https:\/\/securenow.in\/insuropedia\/max-healthcare-hospitals-de-empanel-max-bupa-health-insurance\/","title":{"rendered":"Max Healthcare hospitals de-empanel Max Bupa Health Insurance"},"content":{"rendered":"
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Published in Livemint.
\nMax Healthcare has de-empanelled Max Bupa Health Insurance<\/a> Co. Ltd from its chain of hospitals, leaving policyholders in a fix as they will not be able to avail the cashless claims facility.
\nMax Bupa is a joint venture between True North, an Indian private equity firm and UK-based healthcare services firm Bupa. Max Healthcare is the amalgamation of erstwhile Max India into Max Healthcare and demerger of the healthcare business of Radiant Life into Max Healthcare.
\nInsurance experts we spoke with said that this isn\u2019t the first time something like this has happened but it\u2019s not very often that a healthcare provider de-empanels an insurer. In most cases, it\u2019s the insurer that eliminates healthcare providers from its network if it finds the partnership unsustainable.
\nA Max Bupa spokesperson said the insurer is currently in discussion with Max hospitals on revised tariff plans and that this is a routine exercise. \u201cTemporarily our customers will not be able to avail the cashless facility at Max hospitals. To support our customers and help them cope with the situation, we have started the process of instant reimbursement in which admissible claims are paid within two hours,” said the spokesperson to Mint.
\nAn expert who spoke to Mint, on the condition of anonymity, said that large-scale de-empanelment like in this case, does not happen frequently unless there is an issue with the insurer clearing the outstanding dues of the hospital or not agreeing to the revised rates.
\n\u201cThe contract between Max Healthcare and Max Bupa had expired in May 2019. Max Healthcare has been in discussion with Max Bupa for a fresh contract for the last 15 months and has been extending cashless services to its beneficiaries over all these months even though there hasn\u2019t been a valid contract. In spite of our best efforts, the contract couldn\u2019t be closed to the satisfaction of both the parties and, hence, Max Healthcare has been left with no choice but to suspend cashless services for Max Bupa customers,” said a Max Healthcare spokesperson.
\nAbhishek Bondia, managing director and principal officer, SecureNow.in, said in the past, a similar instance did come up where all the public sector insurers delisted a number of large hospital chains because there was a strong disagreement on the General Insurance Public Sector Association rates. \u201cThis was the insurers de-empanelling the hospitals but it took a few months to get resolved. It\u2019s incumbent on both hospitals and insurers to resolve the issue smoothly because the hospitals may lose patients and confidence in the insurer may go down too if some policyholders prefer getting treated at a specific hospital,” said Bondia.
\nMahavir Chopra, founder, Beshak.org, an independent research platform for retail buyers, said insurers are more dependent on hospitals and would want all major hospital chains to offer the cashless claims facility. \u201cThe negotiating power of an insurer isn\u2019t too much because policyholders decide based on the doctor and the hospital and then check whether the cashless treatment option is available or not. Therefore, if insurers don\u2019t agree to the rates or don\u2019t clear the dues on time, then the hospital may not shy away from delisting the insurer.”
\nThe Max Bupa spokesperson said customers would be able to avail the cashless claims facility at Max hospitals within a couple of weeks.<\/p>\n","protected":false},"excerpt":{"rendered":"

Published in Livemint. Max Healthcare has de-empanelled Max Bupa Health Insurance Co. Ltd from its chain of hospitals, leaving policyholders in a fix as they will not be able to avail the cashless claims facility. Max Bupa is a joint venture between True North, an Indian private equity firm and UK-based healthcare services firm Bupa. […]<\/p>\n","protected":false},"author":4,"featured_media":3773,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[410,319],"tags":[36],"class_list":["post-12910","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-media-coverage","category-media","tag-health-insurance"],"acf":[],"modified_by":"Aishwary Mishra","_links":{"self":[{"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/posts\/12910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/comments?post=12910"}],"version-history":[{"count":3,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/posts\/12910\/revisions"}],"predecessor-version":[{"id":25224,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/posts\/12910\/revisions\/25224"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/media?parent=12910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/categories?post=12910"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/securenow.in\/insuropedia\/wp-json\/wp\/v2\/tags?post=12910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}