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Role of Network Hospitals in Health Insurance

Updated On Feb 08, 2024

Not having health insurance by their side at the time of a medical emergency can lead many people towards massive inconvenience. Right from taking a loan to avail medical treatment or spending their hard-earned savings, there are multiple things that people do when they lack health insurance. Therefore, it is of massive importance for every individual to invest in a good health insurance policy so that they can avoid financial instability during a critical medical situation. 

Health insurance not only provides one with uninterrupted medical treatment but also grants them quality healthcare without having to pay a single penny at the time of a medical emergency. It is because of the facility of cashless treatment at network hospitals that many policyholders can save themselves from significant financial losses. 

What are Network Hospitals?

During the purchase of a health insurance policy, a health insurance company provides a list of hospitals to the policyholder. The hospitals in this specific list are referred to as network hospitals. Health insurance companies and their specific network hospitals have a tie-up for providing the benefit of cashless hospitalisation to the insured individual. 

While the health insurance company provides benefits to the insured through network hospitals by the latter charging a lower fee amount, the hospitals benefit by getting more patients through the health insurance company’s network. 

Hospitals that are not covered in the list of health insurers are known as non-network hospitals. While a network hospital provides cashless services to the insured individual, non-network hospitals require the patients to pay for their treatment make a claim from the insurance company and wait for their reimbursement. 

Benefits of Network Hospitals

One of the biggest advantages of getting treatment from a network hospital is that one doesn’t have to worry about making arrangements for money at the last moment. The health insurer settles the hospital bills directly, thereby taking the burden off from the insured’s shoulders. What’s more, is that the insured individual gets to avail the desired medical treatment without compromising on its quality. 

How Network Hospitals Work?

Talking about network hospitals, when the patient seeks treatment or gets admitted to one of the cashless insurance, he or she is required to submit the form to TPA for cashless mediclaim. Once a cashless claim is approved, the patient can avail the medical treatment.

In this case, all the medical expenses will be taken care of (borne) by the health insurance company. It is important to note that the patient will neither have to submit any kind of bills as well as documents nor worry about the waiting period. However, the only expenses the policyholder will have to bear would be the ones not covered under the policy. 

P.S. Any individual who has not opted for health insurance with a cashless medical treatment facility will be required to go through the whole process of submission of bills and documentation, even when he or she is admitted to a network hospital.

Things to Remember 

In case, you possess a cashless mediclaim policy, it would be better to avail medical treatment in a network hospital. Make sure you always have a list of the best cashless network hospitals ready beforehand so that whenever you have to go for a sudden hospitalisation, you don’t waste time in finding the best one under your health insurance company. 

You can opt for a non-network hospital, in case the desired treatment is unavailable in a network hospital or in case of emergencies. 

How to Find Network Hospitals?

Searching for a network hospital is not as difficult as it seems to be. All you have to do is visit the websites of different health insurance providers and look for the network hospitals tab. Since most health insurance companies have a list of network hospitals based on state as well as location, finding a network hospital won’t be difficult for you. In case, you don’t find the list, do not hesitate to call the insurance company representatives asking for the same.  

How to Choose a Network Hospital? 

  • Start by conducting thorough research on network hospitals. 
  • Make a list of all the network hospitals in your area or an area close so that the commute is easy in case of a necessary hospitalisation. 
  • In the event of a pre-planned hospitalisation, the third-party administrator can be contacted in advance for all the desired approvals.
  • In the event of an unplanned medical emergency, the list of network hospitals you have prepared will help you make the best decision to avail suitable medical treatment. 

Network Hospitals - Do’s & Dont’s 

  • Make sure you remember the name of your nearest network hospital
  • Find out, in case your family doctor comes under the list of network hospitals 
  • Look for the quality, prices (in case of co-payment), and services of the network hospitals near your residence and office
  • Once you have purchased your health insurance, make it a point to keep the cashless card available with you. It is advisable to carry the cashless card in your wallet at all times. 

Find Network Hospitals With the Help Of Insurancedekho?

If willing to find out network hospitals in your area, feel free to visit our website. For instance, if you want to check the network hospitals of HDFC ERGO, go to the insurer page and click on the Network Hospitals tab. You will get a list of all the network hospitals based on city. Thereafter, you can look for network hospitals near your area. The same process goes for Religare, Manipal Cigna, Bajaj Allianz, and other health insurance companies. 

For those interested in learning more about health insurance policies or gaining any other information, contact our experts at 18001205698 right away!

Also Read:

Apollo Hospitals' Founders Are To Sell Their Entire Stake In Apollo Munich

Top 5 Health Insurance Plans with Daily Hospitalization Cash

Conclusion

Network hospitals are of massive significance to every policyholder. On top of that, having cashless mediclaim is even better. Now that you are aware of network hospitals, their concept, and other key aspects, make sure you do not disregard the importance of network hospitals from now on. 

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