Know Difference Between Network and Non-Network Hospitals
Updated On Dec 04, 2020
Differences Between Network and Non-Network Hospitals
It is usually experienced that patients with health insurance are charged more than the patient without it by many hospitals. The insurance companies also realise such a practise being in place and thus they survey the area and get associated with the most frequently visited hospital by their policyholders. They settle a treatment charge with the hospital administration and this becomes a symbiotic relationship, where the hospital gets more patients and the insurance company reduces its losses. The onboarded hospital is termed as a network hospital and any hospital with no association with the company is a non-network hospital.
What is a Network Hospital?
Health insurance providers tie-up with particular hospitals, known as network hospitals. If any insured gets admitted in these listed hospitals, the policyholder can avail cashless claim settlement facility from the insurance company as the bills are directly paid by the insurance company to the hospital.
What are Cashless Claims?
In case of a cashless claim settlement procedure, the insurance company directly settles your medical bills with the hospital. However, health insurance companies provide this facility provided you avail treatment at a network hospital.
What is a Non-Network Hospital?
In case of admission in Non-network hospitals, the insurance holder is supposed to bear the net amount of expenditure for his/her treatment and hospitalization invoice; the policyholder would produce bills to the insurance company, who would then be liable to reimburse the bill amount due to the insurance holder, depending on the type of insurance plan. In case of lodging a reimbursement claim, the policyholder has to submit a set of documents like medical reports, test reports, hospitalization invoice required by the insurance company.
What are Reimbursement Claims?
In the reimbursement process, the insured individual takes admission to a non-network hospital and pays the hospital dues incurred. Once the insured is discharged, he/she submits the copy of the invoice, properly filled pre-authorization form, and other supporting relevant documents to the insurance house, which later reimburses the amount, subject to approval.
Differences Between Network and Non-Network Hospitals
| Difference Factors | Network Hospital | Non-Network Hospital |
| Mode of Payment | The mode of payment, when the treatment is done at a network hospital is always cashless if policy covers the ailment. | The policyholder makes the payment from his own pocket and then raises a claim with all the bills and documents to get reimbursed by the insurance company. |
| Association | Network hospitals are verified by the insurance company and in association with the company | Non-Network hospitals don't have association with the insurance company. |
Conclusion
Needless to say, accessing network hospitals for treatment is always a viable, prudent and preferable option. Parallel to this scenario, realities should never be oversimplified and the matter of immediate emergency health service should be a sole priority.
Hence, it should never be limited to Network hospitals. Health always comes first and in absence of a network hospital, treatment should definitely be availed at a non-network hospital if required.
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.
