Unified medical justifications to enhance healthcare quality, says council

The Council of Health Insurance has called for standardization of medical justifications to boost healthcare quality and enhance the insurance experience for beneficiaries. Unifying medical justifications, the Council explained, will ensure that healthcare services and treatments are medically necessary and clinically appropriate, according to the latest scientific recommendations.

Medical justifications, which the Council defines as approved criteria, determine the necessity and suitability of healthcare services for beneficiaries. These criteria help healthcare providers and insurers deliver and cover suitable health services appropriately, with the goal of improving overall healthcare quality. The Council urged everyone to download the Dhaman app, which offers a range of features including submitting suggestions, inquiries, reports, and complaints, viewing document categories, dependents, approvals, and accessing the medical network.