VIJAYAWADA: Though dengue and malaria cases in the district are around 70 till January this year according to Krishna district officials, the number of insurance claims has crossed 1,400 in August and September alone.
This is due to the practice of private hospitals charging a minimum of Rs 27,000 from patients, who have medical insurance, for viral fevers.
Under Swastha Kutumbam Health Insurance project, which is run by Tata Trusts and Star Health Insurance, insurance claims for viral fevers in 2018 are in thousands. The district officials are discussing with the health insurance providers and asking them to carefully inspect reports before providing insurance and notify them in case there are any irregularities.
According to health officials, private hospitals suspect that patients have Dengue on the basis of results of basic rapid tests such as NS1.
Elisa test is not being conducted and the hospitals are terming different types of viral fevers as dengue, especially if the patients are insured. Speaking to TNIE, I Ramesh, DMHO Krishna district said, “We were surprised to see the number of insurance claims, most in the name of viral fevers. Hundreds of people together claimed insurances worth more than Rs 10 crore. On an average, a small clinic charges Rs 20,000 to treat a viral fever and multi-speciality hospital charges around Rs 70,000 to one lakh. Charging so much to treat genuine cases is understandable but doctors are fleecing people by terming most viral cases as Dengue.”
Dr Sistla Sreeram, a senior consultant with Tata Trusts, who is monitoring Swastha Kutumbam Health Insurance project, says, “Many people fall ill during this season. When they go to private hospitals, they are charged more, especially if they are insured. However, this is happening across the country and everyone is aware of it. Since people do not want to take chances when they’re ill, they follow the doctors’ instructions. We have come across many patients who were discharged right after being admitted to the hospital and subjected to various tests.”
In August, 613 insurance claims for viral fevers were made and in September, to 20th, 882 claims were made for Swastha Kutumbam Health Insurance.
Doctors’ of Association for Medical Ethics are demanding clinical audit in all insurance claims.