Cashless hospitalization is a facility provided by the insurers wherein the insured can get admitted and undergo the required treatment without paying directly for the medical expenditure. The medical expense, thus incurred, shall be settled by the company directly with the hospital. The Cashless claim facility can be obtained only at the hospital network the service provider has a tie-up with.
What is a Network Hospital?
Network Hospitals are those hospitals that your service provider has an agreement with. In case of hospitalization, if you get admitted to a Network Hospital you will be eligible for cashless hospitalization, subject to the other terms and conditions mentioned in your policy being fulfilled. In case you are admitted to a Non-network Hospital, you will have to settle the bills directly to the hospital and then seek re-imbursement through your service provider.
Procedure for obtaining Cashless Health Care
At first the insured must select a hospital from their network tie-ups of their service provider. They must also check booklet of the hospital and also the website of their service provider for more information. They must also have a check on the latest updated list of the hospitals from the list of service provider. Pre-Authorization Request
Pre-authorization is basically an authorization issued either by the insurance company or the service provider, specifying the value of the medical treatment that can be claimable under their insurance policy. To receive a pre-authorization, you need to submit duly fill in the Pre-authorization form. Authorization
After the pre-authorization request has been sent by the hospital to the respective insurance / corporate, it takes a minimum of 24 hours for the hospital to get the approval or authorization for the patient's treatment. For planned surgery or treatment the hospital treat the patient, only after the approval from the insurance / corporate. In case of emergency the patients are admitted and the same will be informed to the insurance / corporate at the earliest.
The Staff members of the Corporate relations department interact and coordinate with the respective insurance / corporate and companies for further clarification or explanation. After the approval from the insurance / corporate, the patient will be informed the same accordingly. Treatment
Cashless hospitalization and treatment are provided to the patients only with approval of the company. Patients should sign necessary documents to facilitate claim processing for the hospital. Patients who don't get approval due to some reason stated by the insurance company are also treated under general patients' category without Cashless hospitalization benefits.