Role Of Network Hospitals In Health Insurance Policy
Published On May 05, 2022
Insurance companies are aware of the fact that private hospitals charge a huge amount from the patients who have a health cover as compared to those who have no health insurance. This means a higher expense and loss for the insurer. In order to manage this situation, the insurance companies tie up with a number of hospitals across the country and negotiate the cost of treatment. These hospitals are known as ‘network hospitals.’ It is an important health insurance term, which has to be understood.
How Do Network Hospitals Work?
Insurance companies are aware that the patients head to hospitals for treatment. In order to handle the situation in the best manner, all the insurance companies connect with hospitals and pre-determine the cost of treatment in order to manage the expenses well. All the hospitals that have tied up with the insurance company are a part of the network hospitals, which are associated with the company. The other hospitals are known as non-network hospitals.
The health insurance network hospitals provide a cashless treatment to the patients. The hospitals, which are not a part of the program or are known as non-network hospitals do not offer a cashless treatment. Patients that seek treatment in non-network hospitals will be required to pay for their treatment and can make a claim from the insurance company.
Individuals who are admitted to a network hospital with a cashless insurance need to make a claim for the expenses incurred and the same will be reimbursed by the insurance company. Individuals covered under a cashless insurance can avail of a cashless hospitalization and treatment without spending anything from their pockets. They will only have to bear the costs that are not covered by the policy.
Advantage Of Network Hospitals
There is a benefit of getting a treatment at health insurance network hospitals as the amount will be paid by the insurance company and the patient will be able to enjoy the best medical treatment. In case of a non-network hospital, the patient can avail of quality medical treatment but the patient will have to make a claim for the amount and the insurance company will only approve the amount it finds reasonable. The insurance company may or may not approve the entire claim. They could approve a partial claim, which means even if you have health insurance, you will be required to bear the expenses of medication.
Thus, it makes a lot of sense to get treatment from a network hospital. When buying the health insurance plan, it is advisable to gain information about the number of network hospitals and the cashless treatment provided there. Keep a list of the network hospitals handy so that you can make the most of the insurance coverage when you need to avail of medical treatment.