Bharatpur, Nov 14: Government-run health insurance has become the main source of income of the Bharatpur Hospital in Chitwan district. It was revealed that nearly 70 percent of the patients who come to the hospital have health insurance policies.
The Hospital Development Committee has to rely on insurance to operate the hospital. The Committee have recruited a large number of medical staff through this income. However, the federal government has provided a small number of staff, which was insufficient to provide efficient health services. Their salary and other benefits depend on the money coming through insurance.
According to the Chief Medical Superintendent of the hospital, Dr. Sriram Tiwari, the total number of medical staff in the hospital today is 1,115. Among them, there are only 154 permanent employees funded by central government.
Moreover, a total of 15 staff from the Maternity Protection Program, nine from the Nutrition Rehabilitation Program, one from the ART Program, two from the OCMC Program, and one training assistant staff are provided by the Government of Nepal and donor agencies.
The hospital has 196 employees for sanitation and security service, and it costs more than Rs. 5.64 crores a year. The central government has been sending only Rs 2.63 crore per year. The remaining amount have to bear by the hospital itself. In total, the hospital spends more than Rs. 50 crore each year for it’s regular expenditure, including salaries and allowances.
The insurance program has started in Bharatpur Hospital from Bhadra 1, 2074 BS. According to Liladhar Paudel, in-charge of the hospital’s health insurance program, the insurance claim was of Rs 52.53 crore for the last financial year 2022/23. This fiscal year (2023/24) more than Rs. 11 crore have been already received by the Insurance Board. The outstanding payment from Insurance Board has exceeded Rs. 25 crores within 3 months of the fiscal year. According to Paudel, we send more than 1,200 policies daily. He says, “In our estimate, it will be more than Rs. 20 lakh daily.”
After the implementation of the insurance program in the hospital, up to the end of the last financial year (2022/23), the hospital has processed a claim of totaling Rs. 1.33 arba. During this period, the hospital submitted 775,151 claims.
According to Paudel, Bharatpur Hospital was the first to claim the most daily. Also, this hospital is also among the hospitals with the lowest number of rejections.
Apart from Chitwan, the citizens of various municipalities in Nawalparasi, Tanuhan, Gorkha, Makwanpur, Dhading and other districts have taken Bharatpur Hospital as their first service point. Paudel says that insurance referral patients come from more than 22 districts.
There are complaints that the process is difficult because the Health Insurance Board has not been able to fully embraced the technology. The chief medical superintendent Dr Tiwari says that if the claim is not paid on time, it causes problems in the operation of the hospital and its impact will be on the clients.
Dr Tiwari said that the policy of Insurance Board has remained same for five years and it should be changed in time. “We have found that rich and poor have the same provisions in the policy.”
Raju Paudel, Chairman of the Hospital Development Committee, says that about 3,000 patients come to the hospital’s outpatient department on a single day, and we have to assign 18 employees to addressing the health insurance program.
Poudel said that the hospital is working to make it easier for the patients who come to the hospital from the health examination to the purchase of medicine. He says that the pharmacy is working to provide all the medicines prescribed by the insurance.
In order to make it easier for insured patients, medicines are given immediately after checking through the counter, medicines are given round the clock through insurance in case of internal and emergency. Paudel said that MRI and cathlab are going to be installed in the hospital.
He says that unnecessary tests, medicine, one person using another’s policy look serious issue.