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Bharatpur Hospital: An excellent model of health insurance implementation

Jan 19, Kathmandu - Tribhuvan University Teaching Hospital decided to stop health insurance from Magh 1. The main reason for this is that half of the claims made by health insurance are rejected and not paid on time.

The government-run Bharatpur Hospital here, which provides more services than Tribhuvan University Teaching Hospital, has a higher amount of money to be paid than Tribhuvan University. But only two percent are rejected.

The hospital has created a separate and systematic structure for the payment and management of health insurance claims. Due to this, insurance employees and administrators from hospitals across the country where the health insurance program is implemented come here for studies. Some hospitals send employees to teach work.

According to Health Insurance Board Information Officer V.K. Malla, the average rejection rate of hospitals on the board is 20 percent.

Stating that Tribhuvan University has said that it is 50 percent, he said that he did not look at all the hospitals separately. He said, “The rejections were made because they did not work according to the procedures and guidelines of the Insurance Board.”

He said that claims were made after treatment even in areas that were mentioned as not eligible for claims.