• Rates are not viable
• We don’t have enough personnel to process documents
• There is no need for another set of rates because the state government has fixed some

These are some of the reasons cited by private hospitals in Calcutta to justify why they don’t want to sign up for Covid-19 treatment packages offered by the General Insurance Council, an association of insurers.

The council had last week come up with Covid-19 treatment packages in NABH-accredited hospitals that proposed a daily limit of Rs 10,000 for patients on isolation beds with moderate sickness, Rs 15,000 for patients with severe sickness and on ventilator in ICU, and Rs 18,000 for patients with very severe sickness.

NABH stands for National Accreditation Board for Hospitals & Healthcare Providers.

This week, some private hospitals in Calcutta have responded to the insurance companies and third party administrators (TPAs).

“A private hospital has written to us saying they don’t have enough staff to process documents under a new package,” said an official of a TPA that has received feedback on the proposed Covid package from several hospitals.

The hospital the official was referring to has recently laid off a number of employees because of a financial crunch.

Fortis Hospital in Anandapur, off EM Bypass, said the rates offered by the insurance council was not viable. An official of the hospital said a study was conducted among 60 Covid patients with moderate to severe symptoms treated at the hospital.

“It has been found that on an average the cost of treating a Covid patient in a ward is Rs 15,000 per day,” the official said. “The cost of treating a Covid patient in an ICU without ventilator support is Rs 40,000 a day and a patient in need of ventilator support Rs 50,000 a day. This includes the cost of protective gear, medicines and investigations.”

Some other hospitals, too, said the rates were not viable.

The Telegraph has reported that the Association of Hospitals of Eastern India, an association of private hospitals in Calcutta, had said it would not accept the Covid-19 treatment packages proposed by the General Insurance Council.

“The rates are not binding on us. The insurance council has proposed the rates but it will be difficult to accept those,” said Sudipta Mitra, the chief executive of Peerless Hospital.

The state government, he said, has stipulated that a patient cannot be charged more than Rs 1,000 a day for PPE and the same amount for doctors’ consultations. The rate of the Covid-19 test has been capped at Rs 2,250. “We are abiding by this rate,” said Mitra.

Insurance companies and hospitals have to come to an agreement on packages for various ailments for cashless treatment. An agreement on rates works for all parties – patients (because they can afford treatment in private hospitals), hospitals (because they get more patients) and insurers (because they get business).

A lack of agreement on a package would mean patients testing positive for the disease would have to continue paying a large part of their bills from their pocket and the allegations of overcharging would continue.

Insurance companies said soon there would be discussions with private hospitals in Calcutta in search of a solution.