Medisep to add dengue and Covid packages in Kerala
THIRUVANANTHAPURAM: New treatment packages for dengue and Covid will be added to Medisep, the health insurance programme for state government employees and pensioners. The new packages are planned for treatments and procedures not part of the approved list of packages numbering 1,920, said a source.
At present, claims for the treatment of dengue, Covid and other unlisted illnesses are honoured from an “unspecified package”. Forming new packages will help avoid confusion among patients and hospitals over the modalities including the upper ceiling. Diseases selected for the packages are those which had a maximum number of claims from the “unspecified package.”
New hospitals
Twelve hospitals have recently signed MoUs and 16 have agreed to sign MoUs. Most of the new hospitals are from north Kerala. Only a specific number of hospitals will be included in the scheme from a particular area. As on July 4, 479 hospitals have partnered with the scheme, including 323 private institutions and 143 public sector ones. Thirteen of them are from outside the state. Amala Institute of Medical Sciences submitted the maximum number of claims, 9, 623, since the scheme’s inception in July last year.
Mobile app
An Android app for the scheme offers different services to beneficiaries, hospitals and outsiders. Beneficiaries can view their profile, dependents’ details and download ID cards. Details on claims, progress of grievances submitted, empanelled hospitals and their specialisations, packages and rates are the other features. The guest login facility will be helpful in case the relatives of a beneficiary want to check hospitals and rates in case of an emergency situation. No personal data can be viewed through guest login.
Grievance redressal
Complaints on claim settlements are to be raised with the insurance company first. Higher appeal authorities are a committee chaired by the district collector at the district level, a committee chaired by the additional secretary (health insurance) at the state level and an appellate authority, including secretaries of finance and health departments. So far, 908 complaints were received.