The pandemic has forced the delivery of a large number of services to be moved online. Telemedicine offers great convenience to many who need to consult a doctor without having to travel to a medical centre or hospital during the lockdown. Teleconsultation has been a boon for people living in Tier 2, Tier 3 towns and even rural areas of the country, where the availability of quality healthcare is an issue.
A recent IRDAI circular has now advised insurers to recognize telemedicine as a valid doctor consultation. IRDAI issued these instructions in lieu of guidelines issued by the Medical Council of India that allowed doctors to provide teleconsultations through telephone, emails and text messages using social media avenues such as WhatsApp and Skype.
Insurers will soon lay down claim processes that accept teleconsultation as a substitute to doctor consultations covered by a health insurance policy.
How the coverage works
Pre and Post Hospitalization Expenses: Doctor consultations are usually covered under pre and post-hospitalization expenses of a standard health insurance plan. With the recent guidelines, you will now be able to claim for teleconsultations as a substitute to face-to-face consultations. Teleconsultations will be covered under similar conditions applicable to Pre and post-hospitalization expenses.
- The teleconsultation should be for a condition for which the person insured is/was hospitalized.
- The consultation is within the specified time period before the admission or after the discharge from the hospital.
- The expenses for the final treatment in the hospital are covered as per the terms and conditions of the health insurance policy.
ePrescriptions generated under Teleconsultations: Apart from pre and post-hospitalization, doctor prescriptions are also required as proof to account for expenses related to follow-up consultation with specialist doctors, carrying out investigative diagnostic tests, or ordering medicines before and after hospitalization. With this circular, insurers are likely to accept ePrescriptions issued by Doctors during teleconsultations as valid documents.Things to note
While you should wait for your insurer to issue guidelines in this respect, in case you need to take any teleconsultations in the interim, ensure the following:
- Use only a credible app, website, or service to consult a doctor through telemedicine.
- All receipts and prescriptions should have the name of the doctor and his registration number.
- All receipts should be system generated and have a unique receipt number.
- Retain all the records of consultation within the healthcare app or website.
- You can additionally keep a record of all the consultations as a screenshot in your device.(The writer is the founder of Beshak.org)