Why India Needs a Unified Hospital Empanelment System for Transparent Healthcare Pricing

In India, hospital pricing remains largely opaque. Patients rarely know the cost of a procedure until they receive the bill. The lack of a unified pricing policy across

empanelled hospitals results

• Price disparity for the same treatment across hospitals
• Ambiguity in package inclusions/exclusions
• Hidden charges post-treatment
• Denied claims due to miscommunication between the insurer and the hospital

This defeats the purpose of having a cashless health insurance plan.

What Industry Leaders Are Saying

Bajaj Allianz CEO on Health Pricing recently stressed the importance of regulation and standardisation:

“There’s a clear need for transparent pricing frameworks. Patients deserve predictability not surprises — in hospital billing, especially under cashless treatment models.”

Such comments from industry experts highlight the urgency of reform.

Why a Unified Empanelment System Is the Need of the Hour

A centralised empanelment framework regulated by health authorities could solve many current issues. Here’s how:

1. Pricing Transparency Across India
   
   All hospitals follow a common pricing template for treatments.
   Patients and insurers can access price lists in advance.
2. Better Access to Quality Care
   
   Empanelled hospital lists are updated and verified centrally.
   Patients can check hospital credentials and treatment limits easily.
3. Reduced Claim Rejections
   Streamlined communication between hospitals, TPAs, and insurers.
   Real-time verification of empanelled status avoids last-minute shocks.
4. Empowered Healthcare Regulator
   A national body can enforce hospital pricing policy reforms in India.
   Periodic audits and digital dashboards can track non-compliance

   Also Read: GST Exemption on ₹5 Lakh Health Insurance: What It Means for You

How It Impacts You as a Patient

Whether you’re insured with a private company like Bajaj Allianz or covered under a government scheme, a unified empanelment system helps you:

• Compare treatment costs across empanelled hospitals
• Ensure cashless admission at partner hospitals without confusion
• Avoid billing shocks due to hidden or inflated charges
• Get faster treatment approval and discharge

Current Gaps in Hospital Empanelment India Must Fix

Here are some urgent gaps that need addressing:

• No national registry of empanelled hospitals across all insurers
• Inconsistent package definitions for procedures
• Limited public access to pricing data
• Lack of patient education around empanelment rules

Until these are solved, empanelment impact on hospital pricing will continue to create friction.

The Way Forward: Making Cashless Treatment Truly Transparent

India is at a crossroads. With digital healthcare expanding and insurance penetration growing, now is the time to introduce a national-level hospital empanelment registry with:

• Uniform pricing models
• Real-time empanelment data
• Transparent cashless claim processes
• Government-monitored audits and grievance redressals

  Also Read: India’s Healthcare Investment Boom: Opportunities & Growth

Final Thoughts

A unified hospital empanelment system isn’t just a bureaucratic upgrade — it’s a patient rights issue. In a country where medical costs can make or break families, transparent pricing and clear empanelment rules are essential.

It’s time India moves towards accountable, patient-centric healthcare — where cashless doesn’t mean clueless.

Are you prepared for your next hospital visit?
Check your insurer’s empanelled hospitals and demand transparent pricing today.

Frequently Asked Questions

1. What is a hospital empanelment system, and how does it work?
A hospital empanelment system is a formal agreement between insurance providers or government health schemes and hospitals. It allows policyholders to receive cashless treatment at listed (empanelled) hospitals under pre-approved packages. However, without a unified system in India, the list of empanelled hospitals, pricing, and services varies greatly across insurers and regions.

2. Why is a unified empanelment system important for transparent healthcare pricing?
A unified system ensures consistent pricing for medical procedures across empanelled hospitals, eliminates billing discrepancies, and reduces confusion for patients. It promotes fairness, prevents overcharging, and ensures that patients receive standardized, transparent care regardless of location or insurer.

3. How does hospital empanelment affect cashless treatment under health insurance?
Cashless treatment is only available at hospitals empanelled with your insurance provider. Without a clear, centralized empanelment list, patients may face treatment delays, denied claims, or unexpected out-of-pocket expenses. A unified empanelment system would ensure clarity and faster claim processing across the board.

4. Who would regulate a national hospital empanelment system in India?
Ideally, a national health authority or regulatory body—such as the Insurance Regulatory and Development Authority of India (IRDAI) or the National Health Authority (NHA)—should oversee the system. This would include creating uniform pricing templates, conducting audits, and resolving disputes between hospitals, insurers, and patients.

REFERENCE: Healthcare regulator, common empanelment for hospitals must for pricing transparency: Bajaj Allianz CEO