Nowadays the practice of cashless insurance claim has increased a lot. Now more and more people are taking advantage of this facility due to hassle-free claims. It is worth noting that the cashless facility is available only in the network hospital of the insurance company.
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Nowadays every insurance company provides its health policy with cashless facility. The advantage of this is that the insured does not have to do paperwork to claim the cost of treatment. The insurance company and the hospital together determine the cost of treatment and the insurance company gives money to the hospital.
In this way, the policyholder neither has to travel anywhere nor does he have to collect much paper. This is the reason that nowadays the trend of cashless claim has increased a lot. It is worth noting that the cashless facility is available only in the network hospital of the insurance company. This means that you can avail cashless facility in the same hospitals with which the insurance company has tie up.
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Is cashless treatment available even in emergency?
Most of the health policyholders believe that cashless facility is available for all types of treatment. But, in reality it is not so. According to a report in Moneycontrol, of course..org founder Mahabir Chopra says that if an insured needs to get treated at an insurance company’s network hospital in case of an emergency, he cannot avail the cashless facility and has to put his pocket first. He will have to pay money from and later he will have to take re-imbursement from the company.
Why cashless claim facility is not available in emergency?
Mahabir Chopra says that pre-authorization is necessary for cashless claims in network hospitals. When you go to a network hospital for treatment under normal circumstances, you inform the insurance company about your hospital admission, treatment and expenses through the insurance desk there. The insurance help desk of the hospital takes your health insurance card and some other documents from you and sends them to the insurance company.
The insurance company evaluates these documents and the information related to your treatment and gives pre-authorization. After this the hospital starts your treatment. When you get treated in the hospital, the hospital then sends the information related to the treatment and the total cost to the insurance company. After evaluating this, the insurance company gives the final authorization and promises to pay the hospital for your treatment. In this way the caseless claim gets settled.
At the same time, if you suddenly fall ill or an accident occurs, then immediate treatment is required. The time taken for pre-authorization in the network hospital is not at that time, as the insurance company usually takes 6 to 24 hours in the pre-authorization process. This happens because the company evaluates your policy and tells whether the treatment you need is covered in the policy or not. Apart from this, some other conditions are also seen. But, in emergency there is no time to wait for approval, immediate treatment is needed. That’s why you have to start treatment by depositing money from yourself. In this way, the facility of cashless claim does not work in case of emergency treatment.
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