Cashless Hospitalization

 Cashless Hospitalization 

Hello, Everyone, 

Now  a days its very important to have a health insurance policy cause in a time of intense economical difficulty, cashless hospitalization will support you better its like  a person who is the policy holder would  not run around for money and paying reimbursement later. here i would like to share my knowledge about the cashless so first of all we need to know what is cashless hospitalization 

cashless hospitalization means your insurance company bear an expenses upon your treatment however we cant predict that how much expense your insurance company will bear for you as per your policy plan. sometimes insurer may cover your full amount of your treatment where sometimes partially coverage provided by your insurer. also we can say that cashless hospitalization is a specific kind of medical facility which helps you to cover your medical expenses towards your treatment.

    Most of the insurance company have their TPA which is the medium which meddling  between insured patients and insurance company in sort TPA settle the bills behalf of the insured person to the insurance company.

now a days there are thousands of plans and policies in the market and that's  makes us a little bit confusing and that's why it becomes very important to know that which plan is best for us  along with our policy 

here we need to know few things which could help us well in the period of hospitalization because its becoming very important significantly because its an option on reimbursement.

1.Choosing  a right policy Plan :-  

As i said there are thousands of plans and policies in the market so you will get to know that which plan is better for you well, in this case your agent will help you however before choosing or buying  health insurance policy its important  to find right agent for a right plan by which there would be no need to pay a single penny while hospitalization however cost towards non admissible amount might be paid by the insured (including additional charges due to opting higher room rent than eligibility or choosing separate line of treatment which is not envisaged or considered in package)

1.Network Hospital:- Before getting admitted its very important to know whether the hospital is in the network of your policy. In case of non network hospital but still you wish to get admitted in the same hospital you will need to go for reimbursement for your claim. you can also check it out online for network hospital for particular city. 

2.Admission Process In network hospital :- Once you confirmed your admission visit insurance department and do all the formalities which is mandatory to do for your cashless claim also do all the documents  submission as per the norms like policy credentials and KYC as soon as possible. however if due to some issues you may submit it before maximum 2 days and minimum 24 Hours. you will need to visit insurance desk time to time until you will not get initial approval. after you did your documentation formalities hospital raise your pre auth request to the insurance company/TPA for your initial approval. you need to understand that every claim has its own TAT time (Turn Around Time) that's the time by which we can understand that how soon or how late the responses raised by insurer.

3.Challenges In network hospital  :- Mostly there are no more troubles to get initially approved for your claim, however sometimes some queries got raised by the patients insurer sometimes some queries are belongs to hospital side and sometimes are from the insured side in such case its get very impotent to solve the said queries from the insured side like demand of any card, id prof,1st consultation paper etc.