Cashless Network Hospital

Have you ever been in a situation where there was a medical emergency in your family, and you required money to deposit at the hospital urgently? If not, then preparation is the key to dealing with these types of emergencies.

Here the cashless network hospital comes to your rescue. All health insurance companies tie up with multiple hospitals to help the insured get the treatment free of cost when covered under a health insurance plan. So, even if you will be in this situation, you will be at ease since you do not need to arrange the last moment funds.

What Is a Network Hospital?

Even though the very thought of being in such a predicament covers you in fear. Given the unpredictability of modern life, it is important to be ready for any unanticipated emergencies. Cashless hospitalisation has been a focus of attention to prevent situations like this. People are now much more aware of the changes that have been made to the health plans of insurance companies.

Without a single hiccup, the insurance companies pay up all the expenditures associated with the hospitals. Your selected health insurance coverage may only cover a certain maximum amount, which will determine how much of your claim will be paid out by the insurance company.

A hospital that is part of your health insurance network is referred to as a cashless or a network hospital. It only indicates that if you seek care at one of these institutions, you can make a cashless claim, which implies that you may go through with your treatment without making any initial monetary payments. However, let’s know in detail.

Cashless hospitalisation ensures that the beneficiary and their dependent family members will not be required to pay any pre-admission fees to the hospital if a medical emergency occurs. They don’t have to worry about medical costs since their insurance provider is responsible for paying their medical claims directly to the hospital. It frees them up to concentrate on getting well.
When you are treated at a hospital that is part of a network and chooses to have cashless claims processed, the bills will be handled in a manner that is coordinated directly between the network hospital and your health insurance provider.
You are alone responsible for paying the remaining costs. However, to avoid complications, it would be best to ensure that any necessary medical treatment is carried out at a facility part of that insurance provider’s network. If you don’t pay your premiums on time, your health insurance coverage will not allow you to get these benefits.

Importance of Having a Large Network Of Hospitals

Network hospitals provide an important function throughout the process of claiming medical benefits covered by health insurance. They simplify the process and make it quicker and more straightforward. Additionally, it will guarantee that the individual will not be charged an excessive amount by the hospital for the treatment or any other medical expenses in any way whatsoever.

When a patient eligible for benefits is admitted to a hospital that is a member of a network, the hospital will ensure that the patient is provided with the maximum possible degree of comfort. When a patient chooses to get treatment from one of the hospitals that are part of the network, the billing and Mediclaim process is streamlined even more.

Why Opt for an Insurer with a Large Network of Hospital Tie-Ups?

For the policyholders to get the necessary benefits in any type of medical emergency, they should study all of the recommendations supplied in the health insurance system. The following is a list of the most important advantages:

You do not need to be concerned about the costs of the medical treatment since the insurance company will be responsible for settling the claim. Get all the required therapies for your health to recover quickly and without any anxiety.
There is no need to worry about making arrangements to deposit the money in the hospital. Cashless therapy is going to be given to you and your family. If the total cost of your treatment is more than the maximum benefit your health insurance plan is willing to pay, then you will be responsible for paying just the excess costs.
The hospital, as well as the TPA desk, are the ones in charge of the paperwork procedure. Therefore, you do not need to be concerned about the same.

Therefore, you must examine the list of network hospitals to know which hospital to go to if you have a medical emergency and want to take advantage of the cashless claim.

How Do Network Hospitals Work?

Network hospitals often have a working relationship with your health insurance provider, eventually enabling you to take advantage of the cashless claims option.

Because you do not have to be concerned about making payments at an already stressful moment, having health insurance in times of need may provide a sense of calmness to the situation.

When it comes to processing cashless claims, network hospitals typically use one of two methods: the first is a planned hospitalisation, and the second is a medical emergency.

Planned Hospitalisation:
Imagine that you need hospitalisation for treatment or need to go through a childcare process and have booked your hospitalisation for a certain day because you require one of these things. If this is the case, you need to inform your health insurance at least three days in advance so that the claim processing may begin on time and you can acquire any necessary permissions on time.

After this, if you need to be admitted to the hospital, you must present your e-health card at the network hospital desk to complete your cashless claim form. After that, you will be good to go. If you want to check yourself into a hospital, you should complete the necessary paperwork in advance to prevent unnecessary delays in receiving care.
Medical Emergencies:
Medical crises may occur at any moment, but sadly they seem to strike when we are least prepared for them. In this situation, it is not feasible to have a scheduled hospitalisation; nevertheless, you should let your health insurance know within 24 hours if you wish to go for a cashless claim at a network hospital.

In this instance, it isn’t easy to have a planned hospitalisation. At the time of your hospitalisation, you will need to provide your electronic health card and fill out the necessary cashless form. Aside from this change, the process will otherwise stay the same.

Differences Between Network and Non-Network Hospitals

Hospitals that are part of a network and not part of a network may have many characteristics, but each facility has unique characteristics. If you are aware of what these hospitals signify and how they might impact your health insurance claim, you will be in a better position to make an informed decision when purchasing a health insurance plan.

The following information will highlight the significant distinctions between hospitals that are part of a network and those that are not.

Points of Difference	Network Hospitals	Non-Network Hospitals
Claim Services	It is possible to file a claim without using cash. On the other hand, if it becomes necessary, you also have the option of using the Reimbursement Claim feature.	There is no mechanism for cashless claims that may be made. Only submit a claim for reimbursement after you have first paid for the treatment out of pocket.
Documentation	For hospitalisation, just a doctor’s note is required, along with evidence of identification for the insured and the policyholder and a health card or policy paperwork from the insurer. The hospital will see to the completion of any remaining documentation that needs to be completed.	To be eligible for reimbursement, policyholders are required to provide the following papers: KYC documents, a health card, a doctor’s note recommending hospitalisation, original invoices and receipts, and data about the policyholder’s bank account.
Out-of-pocket expenses	Low, since at the time of discharge, payment would be required for just the percentage of the bill not covered by insurance, such as consumables, deductibles, co-pays, and so on. The remainder of the costs deemed acceptable by the insurer would be paid directly by the insurer with the healthcare facility.	Extremely high since the patient is first responsible for paying all of the hospitalisation expenses out of pocket, and then a reimbursement claim must be submitted with the appropriate paperwork and papers. It usually takes between sixty and ninety days for the amount of the claim to be credited.
Claim settlement	The process is quick since it must be resolved within two to six hours after discharge.	Delayed because the claim has to be submitted within 10–15 days (the time-after-transaction requirement, or TAT, varies from insurer to insurer), and then it takes another 60–90 days for the claim to be resolved.

Claim Process of Health Insurance

Claims for health insurance may be submitted via a cashless or reimbursement method. Look at these procedures:

Cashless Process:
If you are treated at a hospital part of your insurance network, you can transmit your medical bill immediately to the insurance company. After validating the information, the insurance company will pay the amount directly to the hospital. The following is a list of the actions that must be taken in order to be eligible for a cashless claim settlement:

Step 1: Locate a network hospital:
a. Find a local facility that participates in the insurance company’s network.
b. Get yourself admitted to the medical facility.

Step 2: Inform the Insurance Company:
a. Notify the insurance company that you will be admitted to the hospital.
b. Inform prior to being admitted to the hospital if hospitalisation is scheduled.

Step 3: Get Pre-authorisation:
a. Complete the pre-authorisation form, then hand it to the hospital for processing.
b. The pre-authorisation form will be sent to the insurance company for review and authorisation by the hospital.
c. After approval has been given, you should have the therapy.

Step 4: Hospital Discharge:
a. At the time of release, you will need to sign all of the necessary medical documentation and invoices, if applicable.
b. You are responsible for paying for any services or goods the insurance does not cover in the health insurance plan.

Step 5: Claim settlement:
a. The network hospital will send the treatment bill and other necessary documentation to the insurance company.
b. The hospital will get payment in full for the amount of the bill straight from the health insurance company.
Reimbursement Process:
When submitting a claim using this method, you will first pay the hospital the cost for the services rendered, and then you will send the bill to the insurance company. The insurance will then check the provided paperwork, and if they determine that everything is in order, they will refund you for the money you have already spent on the claim.

You are able to submit a claim for reimbursement regardless of whether you were treated at a network hospital or a facility that is not part of the network. The following is a list of the actions that need to be taken in order to have your health insurance claims reimbursed:

Step 1: Get Hospitalised:
a. Get yourself admitted to a hospital that is not part of your insurance provider’s network.
b. You can opt for a reimbursement claim even if you get admitted to a network hospital.

Step 2: Notify the Insurance Company:
a. Notify the insurance company that you will be admitted to the hospital.
b. If you want to go to the hospital, you are required to inform your insurance before being admitted.
c. Receive medical care and focus on recovery.

Step 3: Hospital Discharge:
a. At the time of release, you are responsible for paying the whole amount owed on the hospital bill.
b. Gather all medical records, bills, and receipts of payments made.

Step 4: Submit Documents:
a. Please ensure that the insurance company receives all of the necessary paperwork.

Step 5: Claim Settlement:
a. The insurance company will evaluate the paperwork and pay the claim amount on the bank details provided by the policyholder.

How to Make a Cashless Claim with any of the Network Hospitals of the Insurer?

Consider the following steps to make a Cashless Claim with any of the Network Hospitals of the insurer:

Step 1: You need to do is decide which of the network hospitals you want to get treated at. You can discover the whole list of hospitals that are part of your health insurance network up top.
Step 2: If you are going to be hospitalised or receiving treatment as part of a scheduled procedure, you are required to inform your health insurance provider at least 72 hours in advance. During an emergency, you are required to do so within 24 hours.
Step 3: At the helpdesk of the network hospital, present your electronic health card and inquire about the cashless request form. After you have completed the form and ensured that everything is in order, the hospital administration will handle the processing of your cashless claim.

Tip: During the process of hospitalisation and cashless claim filing, it is essential to remember to verify whether the treatment you choose is covered by your health insurance policy, as well as by how much coverage it provides. It will ensure that there are no last-minute surprises and delays.

How to Make a Claim When There Are No Network Hospitals in My Locality?

We hope that this will never occur, but if it does, you have the option of filing a reimbursement claim at any other hospital of your choosing. The following is a rundown of the process for filing a claim for reimbursement:

Step 1: If you are going to be hospitalised, please inform us at least 48 hours in advance. If you are going to be hospitalised due to a medical emergency, please inform us 48 hours from the day of admission.
Step 2: After you have been discharged from the hospital, you must send in or upload all of the necessary documentation within 30 days of that date. It is suggested that you do this as soon as possible rather than putting it off, as this will help the procedure go much more quickly and easily.
Step 3: As soon as we have received all of the necessary papers, we will begin processing the claim and repay the needed and authorised claim amount within 30 days, in accordance with the terms and conditions of your health insurance policy.

Things to Keep in Mind When Availing of Cashless Treatment at a Network Hospital

Regarding cashless hospitalisation, one has to be aware of the following essential details:

It would be best if you made it a priority to stay current on the medical insurance hospital list that is available on the website of your health insurance company. This will ensure that you get treatment and have your claim settled without any complications.
Keep all your documentation relating to the hospital with you at all times so you can easily access them when necessary.
Before purchasing a health insurance policy, be sure you have read all the terms and conditions that come with it.
Claim settlement works a little bit differently at each of these businesses. If you pay the claim quickly and without any hassle by following the recommendations provided by your insurance provider.
Remember to have your health insurance card and picture ID evidence when you leave the house. While in the hospital, you should keep this information to yourself.

Conclusion

Every person who has health insurance should pay special attention to the system of hospitals that is available in their region. In a medical emergency, it is a significant relief not to be required to scramble about looking for funds. If you have cashless Mediclaim coverage, it makes perfect sense to go for medical care at a hospital part of the network.

Maintain an up-to-date knowledge of the hospitals covered by your health insurance, paying particular attention to those located nearby if an unexpected medical situation requires you to seek treatment at a hospital immediately.

Frequently Asked Questions

It is not true that you won't have to pay anything after receiving treatment at the cashless hospital, even if it advertises itself as such. If the cost of the treatment results in medical bills that are higher than the maximum covered by the health plan, you will be responsible for paying the additional cost out of pocket.

If you are admitted to a hospital that is part of your health insurance provider's network, you will be able to get treatment without having to pay out of pocket. Following your stay in the hospital, you will have to complete a pre-authorisation form before receiving any medical treatment. Once your insurance provider has approved your treatment, you will be able to get care at that network hospital without paying out of pocket.

Each insurer has a specific list of network hospitals where you can avail of cashless treatment without having to pay anything out-of-pocket except for the portion not covered in the claim. However, you can file a reimbursement claim.

Policyholders who get medical care from a hospital part of a network do not receive any discount. As an alternative, they provide cashless treatment options to the clients of the linked insurance company. As a consequence of this, the insured person is exempt from making any payments at the time of discharge, and their insurance company is responsible for making payments on the hospital bill directly to the network hospital.

No. Your medical expenses will not be lower at any hospital in the network. They will only let you enter a hospital and get treatment if you agree to do so on a cashless basis, citing that your insurance company would pay the cost in full after you have been released from the facility.