TUTH halts health insurance treatment from Jan 15 - english.makalukhabar.com

KATHMANDU: Tribhuvan University Teaching Hospital (TUTH) in Maharajgunj has announced the suspension of treatment services under the Health Insurance Program, effective Magh 1 (Jan 15). The hospital, which has been providing regular treatment services under the program since 2077 BS, cited non-payment by the Health Insurance Board as the reason for the halt, according to hospital spokesperson Kaliprasad Rosyara. Rosyara explained that the hospital has been covering all operational costs from internal resources. With monthly losses reaching around Rs 20 million, it has become unsustainable to continue the program. “The number of patients seeking treatment under health insurance has been increasing daily, costing approximately Rs 50 million per month. However, the Health Insurance Board has approved only 50% of claims, leaving the hospital with unpaid claims of around Rs 400 million,” the hospital notice stated. The spokesperson also highlighted discrepancies between the board’s and the hospital’s rate schedules. Despite repeated requests over the past two years for the board to recognize the hospital’s rates as final, no resolution has been provided.