Things to Know About Cashless Hospitalization

September 21, 2018


Emergency knocks on the door suddenly. It is a well known fact that we should always be prepared for the adversity and when it comes to the well being of our dear ones our primary motive should be to stay alert and prepared for the consequences. A lot of people get trapped in the turmoil at the time of any medical emergency due to the lack of funds. It takes a while to arrange funds and the hospitalization asks for a stipulated amount to at least admit the patient into the hospital and so the cycle begins. Medical bills, medical procedures, tests and medicines pile up to create a huge amount which not anyone can pay. This begets additional stress to the already stressed mind. So, what should you do to avoid this turmoil? What should you do to get help? The answer is quite simple “health insurance”. A health insurance saves you from the complexities and helps you out in the crisis. It is more of like an investment you make for yourself and your family. The insurance covers every little medical expense from the admission of the patient to the discharge. The health insurance is, however, of two types:

  1. The first type of health insurance lets you pay the money and reimburse the amount after checking the discharge papers.
  2. In the second type of health insurance the insurance company directly makes payment to the hospital.

Both of these health insurances, however, ask for a stipulated amount at the time of hospitalization unless you have opted for cashless hospitalization.

What is cashless hospitalization?

Sometimes even after the health insurance coverage some of the hospitals ask for a specific amount and the medical bills are needed to be paid. Cashless hospitalization is one such addition to the insurance coverage which provides an easy benefit of getting the expenses reimbursed. It makes the treatment free of cost resolving the need to wait for the reimbursement. With the cashless hospitalization you are not required to pay the medicals bills rather the company deals with them directly with the hospital. All you need to do is save the bills for further enquires by the insurance company.

The one thing to keep in mind is that cashless hospitalization is available only in few hospitals which are connected to the insurance company. Such hospitals are called as network hospitals. Every insurance company maintains a network of hospitals where you can avail the cashless hospitalization that is, you can carry on your treatment on cashless basis.

Benefits of cashless hospitalization:

  1. You do not need to worry about the expenses and can carry out the treatment without any interruption.
  2. Only non medical expenses are not included in this system and every other expense is included.
  3. Some of the insurance companies provide the advantage of cashless hospitalization even when you are travelling abroad.
  4. You can also claim tax benefits on cashless hospitalization.
  5. Even after the discharge from the hospitals the insurers also provide free medical checkups.

So, how can you opt for cashless hospitalization?

The cashless hospitalization can be carried out in two ways:

  1. Planned hospitalization.
  2. Emergency hospitalization.

Planned hospitalization

Planned hospitalization is the one where you are aware of the hospitalization. If you are unable to plan for the hospital and determine about the list of network hospitals then the first thing to do is check your policy agreement or talk to your insurance provider. Here are some key steps you should follow:

  1. First of all check your policy agreement and look for network hospitals.
  2. Get in touch with the third party administrator (TPA) . You can procure the TPA forms at the insurance office in your city. The form should be filled by the patient and physician.
  3. Submit the filled form in the insurance company for authentication.
  4. The submitted form after authentication is sent to the TPA. The TPA approves the form after enquiries.
  5. Lastly, an authorization is sent to the patient regarding the sanctioned amount details.

Emergency hospitalization

The problem usually arises in the emergency hospitalization when you are completely devoid of big amount in your pocket. The cashless hospitalization serves as a boon in such critical situations. For availing the benefits of emergency hospitalization you should follow these simple steps:

  1. First of all show your insurance card provided by the company at the hospital reception. Make sure it has your policy number on it.
  2. Fill the authorization form at the insurance office to generate the process.
  3. The authorization form is similarly sent to the TPA and sanctioned after the approval. However, you can settle the hospital bill and later file for the reimbursement at the hospital.
  4. Make sure that you carry out the process from the list of network hospitals.

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