Avoid the hassles of paying the amount first and claiming the reimbursement later by getting a health insurance plan that offers cashless treatments to the insured. However, there is a procedure to follow for cashless claims as well. If you don’t follow the process, getting the cashless service might be difficult or you might have to pay the entire hospital bill by yourself. To avoid such a situation, learn how to claim cashless treatments through 5 easy steps:
Step 1 – Choose a network hospital
Before getting a health insurance plans that offers cashless treatment, check the network hospitals. It is possible that you may not find a suitable network hospital near your area. Therefore, confirm these details before hopping in.
We recommend you prefer a network hospital that is near your home or workplace. It is possible to judge whether quality health care services are offered by that particular hospital or not if you have been to any of the network hospitals before.
Step 2 – Inform the insurer
If you are undergoing a planned treatment or surgery, inform the insurer in advance. Also, check if the network hospital you are planning to get admitted to offers the particular treatment or service. Informing at least a week or a couple of days before might help you get a consent letter from the insurer. Submit this letter to the hospital staff before getting admitted.
Also, in case of an emergency, inform the insurance company within the first 24 hours after being admitted. Remember that the health insurance plans consist of accident insurance cover as well. Therefore, getting cashless service for treatment after an accident is also possible. In such cases, you won’t be able to inform both the insurer and hospital in advance. Don’t worry as the insurer will settle the hospitalization expenses even then if you inform them immediately.
Step 3 – Room rent cap
For cashless claims, you don’t have to pay the hospital bills. However, if you have agreed to a copayment while getting the health insurance plan, you need to pay that much. Also, many health insurance plans come with a room rent ceiling or rent cap. It means that if the insurer has set the room rent cap for room rent charges, you would need to pay anything that is above the per-day charge.
For instance, if the room rent limit is Rs. 4,000 and you get admitted to a hospital that charges Rs. 5,000 per day then the additional Rs. 1000 will be payable from your end. Therefore, you should choose medical insurance that does not come with a room rent ceiling.
Step 4 – Exclusions
If you get a treatment done for one of the medical reasons that are mentioned in the list of exclusions, don’t expect to get cashless treatment. It is because exclusions apply to both cashless and reimbursement claims.
For example, if you have a critical illness cover that does not offer health protection to a particular skin disease then you cannot expect the insurer to settle the hospital bills under cashless or reimbursement procedure. Therefore, you must check the list of exclusions and inclusions thoroughly before getting a medical insurance policy.
Step – 5 Submitting documents
Finally, you need to submit all the necessary documents that make you eligible for cashless claims. Take the insurance card provided by the insurance company and identity proofs like Aadhaar Card or driving license while getting hospitalized.
If you follow the above 5 steps, getting cashless claims would be relatively easier. Check the best health cover plans that offer cashless service on the portal of Bajaj Finserv. The details regarding exclusions, inclusions, coverage, etc. would be provided in detail on this site.