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Differences Between Network and Non-Network Hospitals

Updated On Dec 26, 2020

A network of hospitals, health professionals, and hospitals are arranged by each insurance provider that charges their policy buyers a lower fee. In return, more patients are diverted to hospitals through the network of health providers. Health insurance providers know that the insured individual will come to them with large bills in the event of sickness, which means they will have to make major payouts. They negotiate with hospitals and make them a member of their network to change the situation in their favor.

Differences Between Network and non-Network Hospitals

Particulars Network Hospitals Non-Network Hospitals
Meaning In the event of network hospitalisation, the patient is admitted or receives care in one of the insurance company network cashless insurance hospitals.  The non-network hospitals, nevertheless, are the hospitals that are not listed under the agreement with the health insurance provider. ​
Formalities Your stay at a network hospital saves you from the lengthy period of obtaining and filing paperwork for reimbursement. The health care card and the number would simply be used for network hospitalisation.  If you are hospitalised at a non-network hospital, you will have to cover for the bills and then you will look for compensation. Under these situations, most persons must either get support from their family or invest all of their savings.
Arrangement for Cash For cashless medication, the patient may then submit the form to TPA. Once the cashless claim is accepted, the applicant will seek care and the insurance provider may pay all the expenses directly The biggest disadvantage to being hospitalised at a non-network hospital is that all the money has to be arranged first-hand. All the amount that is pending needs to be paid before discharge and only after you make the claim to the insurance provider, you get the reimbursement in 10-15 days
Waiting Time No payments or paperwork will have to be submitted by the patient and there is no waiting time. The only risks that the policyholder can incur are those not protected by the policy.

You will have to carry the medical bills for reimbursement later, but it will be done free of cost from the hospital side. There is a waiting time for the review of the document in a non-network hospital when you make the claim, even after sending all the documentation, after which only you get the insured amount.

Take Away

It makes sense to undergo treatment in-network hospitals if you have a cashless medication scheme. If you have to go through sudden hospitalization, always have a list of the best health insurance cashless network hospitals ready. Opt for non-network hospitalisation only if the network hospitals do not have the required treatment or in the event of an emergency. You deserve the right care in the fastest way possible as a policyholder and receiving treatment from a network hospital helps you with just that.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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