How To Use Cashless Health Insurance At a Hospital?

The coverage enables you to maintain financial stability during medical crises without experiencing mental stress. This blog explains the meaning of cashless health insurance as well as its valuable advantages. All Paybima customers should continue reading this information. Our explanation will be basic and direct. 

What’s Cashless Health Insurance anyway? 

The health coverage lets you avoid making payments directly to a hospital through its network of facilities. The medical insurance firm pays treatment costs directly to the hospital. Your main responsibility centres around improving your health condition. That’s it. 

Patients benefit from a convenient process where they enter a network hospital for treatment before leaving without paying with their cards or spending their savings. 

Sounds lovely, no? 

Why does a network hospital stand as the essential term in this arrangement? 

Here’s the catch: this facility works only at a network hospital. These are hospitals that have a tie-up with your insurer. 

Think of it like this. The insurance company maintains a network of hospitals that it endorses to treat its policyholders. Any hospital within their network will deal with your healthcare costs when you are admitted. 

You must check the network hospital list before making any hasty visits to hospitals. Always maintain the list of network hospitals on your mobile device. The procedure can prevent future situations that lead to unnecessary disruption. 

So, What’s the Process Like? 

Alright. Here’s the real deal. Step by step. Under both operative cases and emergencies, these are the steps behind cashless hospitalisation procedures. 

1. Planned Hospitalisation? Start Early. 

When you or a member of your family requires surgery, the following steps should be taken. You already know the date. You have time. Here’s what to do: 

• Review Hospital Network Participation: Confirm that the selected hospital belongs to your insurance provider’s preferred network organisations. 
• Inform Your Insurer: Life Insurance policyholders need to notify their insurer about pending procedures at least 3-4 days before admission. Sometimes, even a week, if possible. 
• Fill out the Pre-Authorisation Form: The Pre-Authorisation Form requires medical information combined with hospitalisation reasons as well as estimated cost details. The insurance desk at the hospital and its official website serve as sources where you can obtain this form. 
• Let the Insurer Review It: The insurer evaluates all documents together with your policy while issuing their approval. 

Once approved, your treatment begins. The payment is waived since you only need to show your identification documents. Showing both your health card and ID proof to the staff is all that is needed. Smooth, right? 

2. Emergency Hospitalisation? Act Fast. 

Emergencies are messy. Heart attacks, together with accidents and sudden medical operations, create situations where you have no time to organise anything. Even in unpredictable emergency situations, it remains possible to avail of cashless healthcare. 

• Rush to a Network Hospital: A Network Hospital must be your first destination when a medical emergency arises.  
• Fill the Form on the Spot: Alert hospital personnel to provide a pre-authorisation form at their present location. Fill it.  
• Insurer Processes the Request: The insurer handles the request through a fast process, which takes a few hours on average. In emergencies, it’s faster. 

During the period before receiving authorisation, the medical facility occasionally requires a monetary deposit from patients. Don’t panic. The approval process enables an adjustment of the security deposit. 

Process to avail a Cashless Health Insurance Policy 

The entire sequence of using cashless benefits starts at admission and extends through discharge in the following manner: 

1. At Admission: The initial step begins with hospital admission at any network facility, regardless of planned or emergency situations. 
2. Pre-Authorisation: The pre-authorisation process must start when you plan a treatment, since you need to send in the pre-authorisation form before treatment begins. 
3. Treatment Phase: Patients should maintain contact with the insurance desk throughout the treatment period. You must notify the insurance desk about every unexpected change and all unexpected medical issues. 
4. Discharge Settlement: Hospital staff finalise all billing expenses when patients leave the facility in the discharge process. The insurance company receives hospital bills through direct transmission from medical facilities. Once the system verifies everything correctly, your claim approval occurs instantaneously. 
5. Post-Discharge Claims: After hospital discharge, some medical costs may require further reimbursement to the insurance provider. The payment of additional costs at the moment is sufficient for later insurance reimbursement. A proper adherence to each instruction step results in this situation rarely occurring. 

Although the process seems lengthy, it proves more convenient than filing reimbursements subsequently. You will receive quick help through the cashless facility during emergency medical situations.