Cashless Insurance Claims- Cashless health insurance claim facility is available only in network hospitals. It does not work even in some special circumstances.
Cashless Insurance Claim facility provided by insurance companies has removed a lot of problems of the insured person. The benefit to health policy holders is that they neither have to pay from their own pocket for treatment nor do they have to do any paperwork to claim the expenses incurred.
They just have to give their card and the treatment starts. The insurance company and the hospital jointly determine the cost of treatment and the company pays the money spent on the treatment of the patient to the hospital. But, in some cases, even if you have a caseless health policy, you may have to pay from your own pocket.
One thing you should know is that cashless facility is available only in the network hospitals of the insurance company. Apart from this, if you suddenly fall ill and need immediate treatment, then in that situation also you may have to pay the treatment expenses from your own pocket. The hospital may refuse to provide cashless facility here.
Facility will not be available in emergency
According to a report by Moneycontrol, Mahabir Chopra, founder of Bekash.org, says that if in an emergency, an insured has to get treated even in the network hospital of the insurance company, then he cannot avail the benefit of cashless facility. He will have to pay from his pocket and will have to get reimbursement later. This is because pre-authorization is required for cashless claims in network hospitals. But, in an emergency there is no time to get authorization.
Under normal circumstances, when you go to a network hospital for treatment, you give information about your hospital admission, treatment and expenses to the insurance company through the insurance desk there. The insurance company evaluates these documents and information related to your treatment and gives pre-authorization. After this the hospital starts your treatment.
Pre-authorization takes time
At the same time, if you suddenly fall ill, immediate treatment is required. There is no time to take pre-authorization in a network hospital because the insurance company usually takes 6 to 24 hours for the pre-authorization process. Because in an emergency there is no time to wait for approval. Therefore, you have to deposit the money yourself and start the treatment.
