Slowed insurance settlement process delays discharge in 50% patients

As many as 50 per cent of the patients face delay in discharge from the hospitals due to the time taken to process the medical claims, a survey revealed.

According to the survey, done in metropolitan cities including Delhi, Gurugram and Tier II towns, five out of 10 respondents admitted facing delays during discharge due to complex documentation process while settling the health insurance claims.

The respondents selected were between the age group of 18 and 65 years old to which questionnaire was sent online.

“The study indicates that over 40 per cent of individuals attribute delays in health insurance claims in India to hospital administrative processes, while 25 per cent cite a lack of coordination between hospitals and insurance providers. Complex documentation procedures also significantly contribute to these delays,” the study done by Pristyn Care read.

It added, “Survey underscores various challenges encountered by patient families throughout the insurance claims process, with nearly 4 out of 10 respondents reporting difficulties with customer support regarding the claims process.”

The study also found that 6 out of 10 individuals never initiated the health insurance claim process due to exhausting paperwork and delayed responses from the insurance providers, it added. “Among those who did, 34 per cent expressed dissatisfaction with the paperwork, while 40 per cent faced challenges in receiving timely responses from their insurance providers. Roughly 3 out of 10 patients encountered discrepancies between pre-approved and final claim amounts. Around 38 per cent of respondents reported that the discharge process took over 8 hours, with hospitals requiring a similar timeframe to process claims,” it read.

The survey highlighted that the use of Artificial Intelligence and Machine Learning in settlement of claims can reduce the processing time by 90 per cent. New Indian Express