Cashless Claims Resume for CARE and Star Health in Ahmedabad; TATA AIG Still Delisted
The facility and TATA AIG were suspended last month due to alleged arbitrary hospital delisting and refusal to revise treatment rates.
Ahmedabad Hospitals and Nursing Home Association (AHNA) has resumed cashless claim settlements with CARE Health and Star Health.
The facility and TATA AIG were suspended last month due to alleged arbitrary hospital delisting and refusal to revise treatment rates.
Dr. Bharat Gadhavi, President of AHNA, said, “We received representation from both Star Health and CARE and were able to have productive and conclusive discussions with their authorities. Following this, we have decided to reinstate cashless claim settlement for these insurers.”
This decision allows CARE and Star Health policyholders in Ahmedabad to reapply for cashless hospitalization. Earlier, they were required to pay upfront and seek reimbursement.
TATA AIG Remains Excluded from Cashless Network
Cashless claim settlement for TATA AIG remains suspended. Dr. Gadhavi confirmed, “TATA AIG did not reach out to AHNA for any discussions on resolving the matter. Hence, our current stance on not honouring cashless claim settlement for their policyholders across the AHNA hospital network stands.”
TATA AIG had earlier claimed legal action against AHNA, citing hospital malpractices. As of May 13, its website lists around 25 Ahmedabad hospitals as excluded.
Out of 35 AHNA-member hospitals that were reportedly delisted, only 8 are reflected on the TATA AIG exclusion list.
Discussions Ongoing on Hospital Reinstatement
CARE’s current Ahmedabad network includes 151 providers, with 7 AHNA hospitals still excluded. Star Health has 43 excluded hospitals, including 9 AHNA members. No final decision has been made on reinstating these facilities.
According to IRDAI’s 2023–24 report, CARE and Star Health had incurred claims ratios of 57.69% and 66.47%, respectively, while TATA AIG stood at 77.94% for health. Gujarat continues to show a lower ratio of cashless to reimbursement claims, with only 29.43% of claims settled in cashless mode.
Stay tuned for more such updates on Digital Health News
