An important feature in a Group Health Insurance Policy is the GIPSA PPN Network. The full form of GIPSA is General Insurance Public Sector Association.
What is GIPSA?
As the name suggests, GIPSA is an association of four Public Sector Group Health Insurance Companies.
The following four Group Health Insurance Companies in India are a part of GIPSA:
- New India Assurance Company
- United India Insurance Company
- National Insurance Company
- The Oriental Insurance Company
How does the GIPSA PPN work in a Group Mediclaim Insurance Policy?
The Public Sector Group Health Insurance Companies mentioned above have negotiated a standard tariff structure with the hospitals for commonly occurring ailments such as kidney stones, cataracts, angioplasty, appendicitis, knee replacement, kidney transplant.
Hospitals which are a part of GIPSA join the Preferred Provider Network (also known as PPN) of the 4 Public Sector Group Health Insurance Companies and can charge as per the GIPSA prescribed tariff structure only.
In return, the Hospitals which are a part of the Preferred Provider Network (PPN) are allowed to offer cashless claim settlement service to patients who are insured under the Group Health Insurance Policy of these four Group Health Insurance Providers.
The Insured can avail cashless claim settlement only in hospitals which are part of the Preferred Provider Network (PPN) and has to avail Reimbursement Claim Settlement at hospitals which are not a part of Preferred Provider Network (PPN) of these Group Health Insurance Companies.
Additionally, if the Insured avails Reimbursement Claim Settlement at a hospital which is part of the GIPSA Preferred Provider Network, the hospital is supposed to charge the standard rates which have been prescribed by the four Public Sector Group Health Insurance Companies and if the hospitals which are a part of the GIPSA network, charge higher than the prescribed rates, the Group Health Insurance Companies will reimburse the Insured as per the prescribed rates only under the Group Mediclaim Insurance Policy.
The Insured can however complain to the Group Health Insurance Company about being charged higher than prescribed rates by the PPN Hospital.
What is the Empanelment Process for Hospitals to become a part of GIPSA Network?
Hospitals that wish to become a part of the Preferred Provider Network of Public Sector Group Health Insurance Companies and offer cashless claim settlement to Insured Patients need to submit a GIPSA empanelment form along with other required documents to the respective Group Health Insurance Companies. After approval, the hospitals can start offering cashless claim settlement to the Insured Patients of the Group Health Insurance Policy.
There are more than 550 Hospitals in India which are a part of GIPSA PPN network.
What are the advantages of GIPSA PPN Network in a Group Health Insurance Policy?
The GIPSA Insurance Companies cap the rates which can be charged for commonly occurring ailments by the hospitals.
This allows the Group Health Insurance Companies to charge lower rates for providing Group Health Insurance Coverage and this makes the Group Health Insurance Policy more affordable.
Another advantage is that the Insured can avail Cashless Claim Settlement at hospitals which are a part of the Preferred Provider Network.
Get a Free Quote for Group Health Insurance Policy from Qian!
Qian offers customised Group Health Insurance Plans at competitive prices. The main advantage of a Group Mediclaim Insurance Policy is that the premiums are lesser than Individual Health Insurance Policy and every business should consider purchasing a Group Health Insurance Policy for its employees. The Tax Benefits of a Group Health Insurance Plan also make it more affordable to purchase a Group Health Insurance Policy for Employees.
Qian specialises in Group Health Insurance Plans for Small Business and has partnerships with top group health insurance providers to provide comprehensive Group Health Insurance Coverage for its clients.
So, if you wish to purchase a Group Medical Insurance Policy for your organisation, give us a call or email us at insurance@qian.co.in. Our experts will be glad to assist you.
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