Parbat, Feb 1: The provincial hospital in Parbat has plunged into a severe crisis due to the prolonged non-payment of health insurance claims from Health Insurance Board.
Provincial Hospital Parbat has been unable to receive more than Rs 30 million in payments for treatments provided to insured patients. Chief Medical Superintendent Dr. Dhundi Raj Paudel said that outstanding payments dating back to the previous fiscal year (2024/25) —covering health insurance services and dialysis — have seriously affected hospital operations.
The Health Insurance Board (HIB) is required to reimburse hospitals for tests and treatments provided to insured patients. However, delays in payment have caused the outstanding amount to increase steadily. In recent times, many hospitals have stopped services under health insurance schemes provided by the HIB.
Dr. Paudel stated that the lack of reimbursement has created difficulties in purchasing medicines and equipment, paying staff salaries and allowances, and managing regular hospital operations. Despite repeated requests for payment, no response has been received.
“Insured patients visit the hospital even for minor health problems, and we are obligated to provide services. But due to delays from the Health Ministry and HIB, we are facing problems in supplying necessary medicines, medical supplies, and laboratory services,” he said.
Nearly 45 percent of the district’s population enrolled in the health insurance scheme receive services from this hospital. He further explained that although the Health Insurance Board has forwarded the hospital’s billing details to the Ministry of Health, payments have yet to be released, pushing the hospital toward crisis.
Under the scheme, a family of five pays an annual premium of Rs 3,500 and receives insurance coverage worth up to Rs 100,000. For families with more than five members, an additional contribution of Rs 700 per person is required, and treatment coverage increases by Rs 20,000 per additional member, up to a maximum of Rs 200,000 per year.
A few days ago, a memorandum was submitted to Minister for Health and Population Dr. Sudha Gautam during her visit to inspect the hospital, requesting the immediate release of insurance payments. On that occasion, Minister Gautam acknowledged that hospitals across the country are facing similar problems and said the government is working to manage the required budget by exploring various funding sources. #nepal #insurance
