Mandatory Documents for Cashless Treatment Insurance

One can make a good decision by purchasing health insurance for themselves as well as for their family. But the main thing is to know how to use that insurance and their process. Health insurance companies provide claims to their customers when they need them in medical emergencies. To file the claim you should know what document is required and it will make your claim process more efficient and smooth. In this article, we will let you know about the mandatory documents required for cashless treatment. 

What is Cashless Treatment Insurance?

Cashless treatment insurance is a facility provided by the health insurance company, and you can take cashless treatment at network hospitals without paying from your pocket. In simple terms, the insurance company will directly settle the hospital bills of their customers as long as treatment is covered under your policy.

Document Required for Cashless Treatment

The documents that are required for filing the cashless claim are:

Health Insurance Card or Policy Documents

The health insurance card or policy document is required at the time of hospitalisation and it is required for verification.

Photo Identification

A valid government-issued ID such as an Aadhar card, driving license, PAN card, or voter ID will be required for verification.

Pre-authorization Form

This form will be provided by your insurance company and you have to fill and submit it before the treatment begins.

Procedure of Cashless Claim Settlement Process

The steps for the cashless claim process are as follows:

Step 1: Get Treatment at Network Hospital 

The very first step of the cashless claim process is to get treatment at a network hospital.

Step 2: Inform your Insurer

To get the benefit of cashless treatment you have to inform your insurer 48 hours before planned treatment and within 24 hours for emergency hospitalisation.

Step 3: Inform Hospital

Inform the hospital during hospitalisation that you have health insurance and show them your health card.

Step 4: Pre-authorisation Form 

Fill out the pre-authorisation form which is provided by your insurer.

Step 5: Provide Identification Proof

For the proof of patient such as an Aadhar card, driving license, PAN card, or voter ID.

Step 4: Bill Settlement

When you are done with your treatment your insurance company will directly settle the hospital bills.

Documents Required for Pre and Post-Hospitalization Expenses

There are certain documents that are required to get the pre and post-hospitalisation expenses and those documents are: 

Pre-Hospitalisation Expenses 

Medical Report - Documents of any tests, advice, or drugs taken to deal with the disease or illness that required hospitalisation.

Bills and Receipts- Original bills and receipts for expenses incurred before hospitalisation, such as doctor's visits, diagnostic tests, or medicines.

Prescriptions- Copies of prescriptions for any medications taken before hospitalisation.

Post-Hospitalisation Expenses

Discharge Summary- A detailed summary of your hospital stay, including diagnosis, treatment, and recommendations.

Bills and Receipts- Original bills and receipts for expenses incurred after discharge, such as follow-up consultations, medications, or rehabilitation services.

Medical Certificates- Any medical certificates or reports related to post-hospitalisation care.

Reimbursement Form- A completed reimbursement form provided by your insurance company.

Methods to Submit Documents for Cashless Treatment

There are two types of methods to submit documents for cashless treatment one is online mode and another is offline. Go through the below-given methods to submit documents for cashless treatment: 

Online

Website: you can submit your document for cashless treatment at the company's official website. 

Mobile App: Some insurance providers have mobile apps that allow you to submit documents directly from your smartphone.

Offline or Physical Mode

Hospital: In some cases, you may need to submit documents directly to the hospital where you are receiving treatment. The hospital will then forward them to your insurance provider.

Insurance Company's Office: You can also visit your insurance company's office and submit the required documents in person.

What Happens if You Fail to Submit Mandatory Documents?

If you will fail to submit mandatory documents for cashless treatment then there is a high chance that your claim will get delayed or it will get rejected. So it is highly recommended that submit the documents which are requested by the hospital and insurer.

FAQs

Ques 1. What are the rules for cashless claims?

Ans. The very first rule for cashless claims is to get treatment at the network hospitals. You will only get a claim for cashless treatment when you get a treatment at the hospital that has a tie-up with your insurance company.

Ques 2. What is a pre-authorization form?

Ans. It is a request form that must be submitted to the insurer by the customer to obtain approval for cashless treatment.

Ques 3. Can I avail of cashless treatment without a health insurance card?

Ans. Some insurers accept policy numbers or digital copies, but it’s best to carry the physical or digital health card.

Ques 4. Are there any time limits for submitting the pre-authorization request?

Ans. Yes, hospitals typically need to submit the request within 24-48 hours of hospitalization, depending on the insurer.

Ques 5. Is cashless treatment available at all hospitals?

Ans. No, cashless treatment is not available at all hospitals you will only get cashless treatment at the network hospitals. Network hospitals are the hospitals with whom insurance companies have tie-ups