How Cashless Health Insurance Claims Work
Updated On Dec 05, 2020
When every sector in India is moving towards cashless, insurance has also taken a step in this direction. Those days have passed when the policyholders had to wait for the crisis to get over to get the money back from the insurance company. The motive is simple – to make them feel more secure than ever and reduce their monetary burden.
Now, one does not have to worry about incurring expenses immediately during a medical emergency. With a cashless health insurance policy in the kitty, the policyholder is free from the troubles of paying hospital charges. The insurance company is in charge of settling these bills with the hospital itself.
Reimbursement Vs Cashless Health Insurance
| Basis | Usual Reimbursement Policy | Innovative Cashless Policy |
| Payment | The policyholder settles the hospital’s payment | The insurance company pays the hospital bills |
| Comfort | Excess worry because of funds arrangement at the time of the misfortune | No worries as the insurance company handles the funds |
| Paperwork | Lengthy paperwork and record of every document | Minimum paperwork on part of the policyholder |
The traditional insurance policy requires submission of all the necessary medical documents after getting treatment. So, this means emptying the pockets first and getting them filled again later. Cashless health insurance saves the hassles of running here and there for money in times of crisis.
Working Of Cashless Insurance
Cashless means effortless. Cashless health insurance works only at the network hospitals of the respective insurance company. They have a list of network hospitals where one can avail of the benefits of the cashless policy. The insurance company has an association with them that allows them to settle the bills directly.
Steps Involved In The Cashless Health Insurance Process
This policy requires the policyholders to follow these easy steps to reap the advantages of cashless insurance:
- To avail medical benefits from this policy, choose from the list of network hospitals of the insurance company.
- At the hospital’s insurance desk, ask for a pre-authorization form in which all the details are filled about the treatment.
- The hospital sends the form to the company or Third Party Administrator (TPA) for approval and processing.
- Once they approve it, the policyholder is eligible for direct coverage.
In case there is an emergency, the insurance desk at the hospital tries to speed up the approval process.
Advantages Of Cashless Health Insurance
Needless to say but if the reimbursement insurance policy is considered a necessity, the cashless policy is a combination of essential + comfort.
- No extra financial responsibility is imposed on the policyholder in case of an emergency. There is less stress of getting coverage claims in planned hospitalization as well.
- Since the insurance company takes care of the hospital payments directly, the policyholder needs not to draft long paperwork and documents.
- There is a minimum waiting period to avail the policy benefits. One does not have to run immediately after receiving treatment to claim the reimbursement.
- The cashless health insurance experience is smooth and less burdensome.
Conclusion
When a person has a cashless health insurance policy, it is like having airbags in a car for unprecedented conditions. It comes in handy to stay relieved of financial stress in any medical situation. Furthermore, it provides peace of mind that one is up for a hassle-free encounter in an odd state of events.
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.
