With the aim to lower disputes between insurance companies and healthcare providers, the General Insurance Council (GIC) on Monday published a schedule of rates for the treatment of covid-19, a respiratory disease caused by the novel coronavirus. The rates are based on suggestions made by a Niti Aayog panel. However, hospitals do not seem to agree with the rates.
The proposed rates shall be applicable to both cashless and reimbursement claims in all states where government authorities have not prescribed standard charges for covid-19 treatment.
The GIC has proposed different rates per day for NABH-accredited hospitals and non-NABH-accredited hospitals based on the severity of the case.
For moderate sickness which requires isolation beds including supportive care and oxygen, hospitals are asked to charge ₹10,000 per day in a NABH-accredited hospital and ₹8,000 in a non-NABH accredited hospital. The rates include cost of personal protection equipment (PPE) at ₹1,200.
For severe sickness which requires admission in an intensive care unit (ICU) without ventilator, hospitals are allowed to charge ₹15,000 and ₹13,000 respectively (including ₹2,000 for PPE costs).
Finally, in case of very severe sickness where the patient requires ICU with ventilator care, hospitals can charge ₹18,000 (NABH-accredited) and ₹15,000 (non-NABH-accredited).
These rates include the cost of consultation, nursing charges, room stay, and meals, covid testing, monitoring and investigations, biochem and imaging, physiotherapy, PPEs, drugs and medical consumables, biochemical waste management, bedsides procedures like Ryle’s tube insertion and urinary tract catheterization.
However, interventional procedures such as central line insertion, chemoport insertion and bronchoscopic procedures, and high-end drugs such as immunoglobulins and meropenem are not included in the prescribed rates. Such items shall be charged at MRP by the hospital. Further, high-end investigations such as MRI and PET scan will also not be included.