Karnataka accounts for the second highest number of hospital claims raised in the country under Ayushman Bharat-Arogya Karnataka (AB-ArK) after Andhra Pradesh (AP) for cashless Covid treatment, data from Suvarna Arogya Suraksha Trust (SAST) revealed.
The state has received 2.68 lakh claims for Covid treatment since March 2020. As many as 1.02 lakh claims worth Rs 504 crore have been settled as on August 4.
The government says the scheme’s appeal is due to the fact that during the pandemic, even interstate migrants and returnees were covered for Covid treatment under the scheme, increasing its reach.
While 62.09 lakh below poverty line families are supported by the government of India, under AB-ArK, another 53 lakh below poverty line families of Karnataka are taken care of by the state government under the same.
SAST executive director N T Abroo, who oversees AB-ArK, said, “AP leads with the number of claims, but it has a hybrid model of providing insurance and not a trust model like Karnataka. Also, the number of empanelled hospitals are highest in Karnataka.”
Another plus point of the state is human resources.
“No other state has 900 arogya mitras deployed in each empanelled hospital hand-holding the public and a team of 100 doctors verifying each claim raised by hospitals, leading to a quick turnaround time,” she said.
Pre-pandemic, there were only 500 arogya mitras, for facilitating patients’ treatment.
An additional 200 arogya mitras were deployed after the pandemic started. Deputy commissioners of various districts also deployed around 200 arogya mitras in hospitals across the state to help patients’ families.
On the non-Covid front, the state has given 15.78 lakh pre-authorisations worth Rs 2,655 crore.
Claims submitted so far are 14.46 lakh worth Rs 2,281 crore, out of which paid claims include 10.85 lakh, worth Rs 1,872 crore.
On complaints by private hospitals of non-payment of Covid dues by the government, Abroo said, “Covid plus non-Covid claims of around 11.87 lakh, worth Rs 2,052 crore have been settled. Claims received amount to Rs 2,281 crore. So, the leftover claims to be settled are worth only Rs 129 crore. This means 89.96% of the claims have been settled. How can private hospitals claim non-payment of dues?”
She said 95% of the claims from the first Covid wave had already been paid for. Only 4% payment for hospital claims were denied as hospitals had not given proper documents.
“Claims under the second wave are being submitted only now,” she said, adding that 14.5 lakh citizens have been treated under AB-ArK so far.
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