The Union government will soon release a standardised format for hospital bills applicable to all clinical establishments, including hospitals, nursing homes and diagnostic centres, says
a report from New Indian Express.
The report says the standard being developed by the Bureau of Indian Standards (BIS) and the Union ministry of health and family welfare (MoHFW), in consultation with healthcare sector experts, patient advocacy groups and other stakeholders, will help patients get itemised details for all consumables, services and medical facilities.
The draft also prescribes mandatory and optional elements to be included in hospital bills issued by healthcare facilities nationwide.
A top official from MoHFW told the newspaper that a standardised framework for hospital billing has become imperative. "The aim of standardising billing formats across all healthcare facilities is to promote uniformity and reduce discrepancy in billing practices."
Transparency in billing will help not only the consumers but also health insurance companies, employers who give reimbursement packages and even the governments - both Central and state, some of which provide healthcare schemes.
Last year, Veterans Forum for Transparency in Public Life, a non-government organisation (NGO), brought to the notice of the Supreme Court a major discrepancy in hospital rates. In the public interest litigation (PIL), the NGO highlighted how the cost of treatment varies between private and government hospitals and sought the Union government to determine the fee chargeable to patients based on rule 9 of the Clinical Establishment Rules 2012.
After hearing the matter, a bench of justice BR Gavai and justice Sandeep Mehta directed the Union government to take immediate action on the issues raised in the PIL. "If the Union government fails to find a solution, then we will consider the petitioner's plea for implementing central government health scheme (CGHS)-prescribed standardised rates," the bench warned.
According to data from the insurance regulatory and development authority of India (IRDAI), only 71.3% of the Rs1.2 lakh crore claims that were registered and outstanding during FY23-24 were paid.
The insurance regulator's report reveals that insurers registered over 30mn (million) claims during the year for Rs1.1 lakh crore, in addition to the 1.79mn claims for Rs6,290 crore outstanding from earlier years. Of these claims, insurers paid nearly 27mn claims, amounting to Rs83,493 crore. This represents 82% of the reported claims by volume and 71.3% by value. Of the claims that were not paid, Rs15,100 crore worth were 'disallowed according to terms and conditions of the policy contract'.
Last year, in a survey,
community social media platform LocalCircles pointed out that while 47% of respondents were happy that the hospital bills they received had details about all the expenses whether products, consumable, services or facilities, the remaining 53% did not receive these details. "This discontent is reflected in the response received to the next question with 74% of respondents wanting the government to initiate action via BIS to help create a common billing format for all hospitals giving details of all the charges levied."
Even for insurance companies, non-standardisation of hospital bills is one of the major hindrances to provide the cashless facility to patients across the country.
Following the nudge from the apex court, the Union government asked BIS to develop a standard format for hospital billing. Official sources told New Indian Express that summary of charges will include a clear and itemised breakdown of all charges like per day rent, type of room, charges for doctors and specialist consultations, surgery charges, surgeon fees, anaesthesia charges, operation theatre charges, list of all diagnostic tests and their charges, list of medicines dispensed, their quantity, price, batch number and expiry date, medical consumables and disposables, items such as syringes, gloves and catheters, their quantity, price, batch number and expiry date and nursing charges.
"Optional elements are likely to be at the hospital's discretion and may include details like names, designation of attending doctors, breakdown of surgery and procedure charges, concessions, emergency contact details, blood group, or other relevant medical information, and discounts or concessions," the report says.
