Cashless hospitalisation is a great way to reduce the financial burden of medical treatment. Learn what is involved in cashless hospitalisation and how you can benefit from it.
Cashless hospitalisation in medical policy is a process where the medical expenses are settled between the hospital and the insurance company directly. Cashless hospitalisation eliminates the need for patients to pay out of pocket for medical expenses, which can be a huge financial burden for many people. There are several steps involved in the procedure for cashless hospitalisation, and it is important to understand these steps in order to ensure that you are properly covered.
This article will go over everything you need to know about cashless hospitalisation, including its coverage and process.
Navigate through the article:
What is cashless hospitalisation?
Several insurance firms have tie-ups with top hospitals in India, resulting in a strong network of institutions where their members may receive cashless care.
While selecting a plan, it is a good idea to look into the insurance company’s network hospitals. Additionally, browse over your policy paperwork and examine the network hospital database to get a sense of the more popular or established hospitals in your area. This is significant because, in the event of scheduled treatment, you might have the opportunity to examine network facilities and pick one that fits you, but in a crisis, a network facility may be hard to locate if you haven’t already checked the database.
In any case, cashless therapy is only available at network medical facilities. You must notify the insurer of the admission after it has been completed. From this point on, the insurer handles everything with the doctor and simply needs your help with any paperwork that may be needed. The hospital will ask for your insurance details and verify the status of your coverage. When your insurance data has been validated, your cashless healthcare treatment will begin. In this case, your insurance provider will pay the hospital straight when the therapy is completed.
Why is cashless hospitalisation important?
Cashless hospitalisation can be a great benefit, especially for young adults. If you are trying to decide whether or not it is the right choice for you, there are several things that you need to take into consideration. Here is why cashless hospitalisation is essential for the insured:
- Financial relief
Cashless health insurance claim settlements have revolutionised the medical insurance space. The major advantage of this type of settlement is financial convenience. With cashless health insurance, you can pay medical bills directly from your insurance account, thus avoiding the hassle of filing claims and waiting for reimbursements. Not only is it less cumbersome, but it also helps to save time and money. This cashless system is definitely a boon to both patients and healthcare providers.
- Best treatment
Cashless health insurance claims offer the best treatment at low or even no out-of-pocket expenses. It’s a great option for those who have a medical policy and want to make sure they’re getting the best care. With this type of claim, you don’t have to worry about paying for medical treatments out of pocket as the insurance company covers the cost, and you just have to provide your policy information for the medical facility to process your claim.
- Minimal paperwork
Cashless health insurance claims are becoming increasingly popular due to their convenience and minimal paperwork. Rather than having to submit claims manually, the hospital bills are automatically forwarded to the insurance company by the hospital authority. This streamlines the process and makes it easier for everyone involved. Furthermore, cashless health insurance claims also allow for quicker reimbursements and reduced waiting times.
- Savings
Cashless health insurance claims are a great way to save money as an insured. With this type of claim, you don’t have to pay any money out of pocket, except for the deductibles. This makes it a great option for those who don’t have a lot of extra cash or are on a strict budget. Furthermore, cashless claims offer the convenience of not having to wait for reimbursements from the insurance company.
- Wide coverage scope
The cashless claim service in medical policy covers a wide range of healthcare costs, providing you with total financial comfort. Aside from hospitalisation charges, cashless claim payments cover the expenses of treatments, physician’s fees, surgeon’s fees, nurse’s fees, expenses of blood, oxygen, medications, daycare therapies, organ donations, and so on.
What is covered under cashless hospitalisation?
Here is a list of cashless hospitalisation inclusions:
- Room rent
- Surgeon’s fees
- Nurse’s fees
- Anaesthetist’s fees
- Organ donor treatment
- Blood
- Medicine
- Oxygen
- Daycare therapy
- In-patient treatment
- OT charges
- Domiciliary treatment
- Alternative treatment
Note: This is a generic list of inclusions within cashless hospitalisation. For a more detailed list, refer to your policy documents or contact your insurance provider.
What is not covered under cashless hospitalisation?
Here is a list of cashless hospitalisation exclusions:
- Specifically excluded treatments
- Cost of consumables
- Hospitalisation for non-covered claim instances
- Documentation costs
- Attendant costs
- Service charges
- Toiletries
Note: This is a generic list of exclusions within cashless hospitalisation. For a more detailed list, refer to your policy documents or contact your insurance provider.
How to process cashless hospitalisation?
Here is a step-by-step breakdown of cashless hospitalisation:
- Choose a network facility in your locality and notify your insurance company within 48 hours before hospitalisation (for emergencies) or at least three days before hospital admission (for planned cases).
- While visiting a partner hospital, be sure to bring the policy information or the patient’s insurance health card, which is issued with the policy paperwork.
- At the facility’s insurance department, show a valid ID as well as an insurance cashless health card.
- Fill out the pre-authorisation form completely and return it to the hospital.
- Fill out an application form on the online site and notify your insurance company to accelerate the process.
- It may take a couple of hours for your insurance company to assess an application and provide you first approval through SMS or e-mail. You may even monitor the claim’s status on the insurer’s website.
- Once treatment is finished, the final invoice, in addition to the discharge narrative and original invoices, will be forwarded to the insurance company for final approval.
- The final approval is obtained at the time of release and is handled directly by the hospital.
- You must give your bank information to the insurer, such as a copy of your cheque/passbook/bank statement.
- If the final approval is received, you can use the cashless service to settle the claim. Just a tiny fraction of the price, often the consumables component, must be borne by the customer because it may be omitted from the policy.
Conclusion
If you’re in India, you are almost certainly covered by one of the many insurance providers in operation. Cashless hospitalisation makes it easier for those with insurance to handle their medical expenses and get their needs met without worrying about higher costs. It’s up to you to ensure that your insurance provider covers cashless hospitalisations, but the process is straightforward and doesn’t require much in the way of fees or red tape.
Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.
