subject: Cashless hospitalization in India [print this page] Cashless hospitalization in India Cashless hospitalization in India
Cashless hospitalization is one of the most important aspects which need to be considered when buying health insurance. Medical insurance is necessary for every individual keeping in mind the rising medical cost. Today, medical treatment costs have reached an all time high and are further expected to rise. Sickness, diseases, accidents can strike anyone, anytime, leaving you devastated emotionally as well as financially. Though one cannot provide coverage for emotional loss, financial losses during a medical emergency can be certainly covered under a health insurance policy.
As mentioned cashless hospitalization is one of the most important aspects of a comprehensive health insurance policy. Most health insurance providers in India offer cashless hospitalization to its customers. Medical insurance providers in India have tie-up with certain number of hospitals across the country to provide cashless hospitalization to its customers. In cashless hospitalization, all the relevant medical expenses covered under the insured's policy are directly settled by the health insurance provider with the hospital. This process takes place with the help of a third party administrator (TPA), which health insurance companies hire to assist them during a claim. An insured needs to submit all the relevant medical documents to the TPA for successful filing of a claim. The claim is approved by the health insurance provider once reviewed and accepted by the TPA.
Though a TPA is hired for convenience of health insurance companies the process of filing a claim is usually elongated due to a TPA. To avoid this and other hassles to customers, some health insurance providers settle claims directly without any TPA involvement.
It is always advisable to get treated in hospitals which fall under the network list of the health insurance provider (Cashless Hospitalization). In cashless hospitalization all the treatment costs are settled directly by the health insurance provider with the hospital without letting the insured shell out any amount from his pocket.
For treatment taken in hospitals which do not offer cashless hospitalization, all the medical expenses have to be borne by the insured initially and later reimbursed with his/her health insurance provider. Also health insurance providers do not reimburse the medical treatment cost completely if treatment is taken in hospitals other than network hospitals but upto 80% of the entire medical treatment cost. The rest 20% have to be borne by the insured from his/her pocket.
