IRDA arm creates hospital registry
11 Mar, 2014 01:01 PM
The Insurance Information Bureau (IIB) - a body created by insurance regulator IRDA - has created a registry of healthcare providers and assigned them unique IDs. Creation of this database is the regulator's first step in building an analytics capability for detecting endemics, assessing medical cost inflation, and in detecting fraud.

Speaking to TOI, R Raghavan, head of IIB, said that the unique hospital ID registry is a compilation of all the hospitals that are currently in the provider network of health insurance. "The intention is to make the registry open to all hospitals who would like to enrol for future association with health insurers or third-party administrators."

The IIB is also part of a panel under the ministry of health and family welfare, which is developing a template for standard procedures for various ailments. Along with the standardization of procedures, the ministry is also coming out with a costing template. With insurance companies submitting claim data incorporating disease codes, procedure codes and hospital IDs, the regulator would be able to run its fraud analytics software.

Last month, the regulator had made out a request for proposal from providers of fraud detection software. Health insurers say that the software should throw up hospitals where billings are out of kilter or there is a pattern.

According to Sandeep Patel, MD & CEO of Cigna TTK Health Insurance, there is no standardization at present in India with respect to procedures. "The creation of this database will help to analyze and determine the consistency in pricing by hospitals and in turn help us determine how much leeway we can give in terms of pre-authorization," said Patel.

Other health insurers are also very positive on the move to build the hospital registry since there is no accreditation of hospitals in India. "This is a very good initiative. With this as the base, we can start having physical inspections and even map hospitals with GPS," said Segar Sampathkumar, general manager, New India Assurance. At present, insurers know of the existence of many healthcare providers only on paper.
Source : The Times Of India

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