Claim settlement is one of the most important services that an insurance company provides you. Insurance companies are bound to settle the claims promptly. Every product has a different claim process which you might go through. You must know the process of claim before initiating with it. Here, we attempt to help you provide the information on the claim process. This will tell you what information you need before you get in touch with your insurance company and what you can expect from the claim process.
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Cashless hospitalization is a facility provided by the Insurance Company wherein the policy holder can get admitted and undergo the required treatment without paying directly for the medical expenditure. The eligible medical expense, thus incurred, shall be settled by the Insurance Company directly with the hospital. The Cashless claim facility can be obtained only at the hospital listed in the network of the Insurance Company.
Hospitalization happen under two circumstances - planned and emergency
Once your doctor has recommended for the hospitalization, contact your insurer immediately and inform about the hospitalization.
In case of emergency hospitalization, you must inform your insurer within 24 hours of hospitalization.
Get admitted to the hospital by showing your health ID card or policy number for identification purpose.Hospital will check your identity and fills up the Pre-Authorization Form with all the relevant details and send to the insurer.
Ready with you the below documents to be sent along with the pre-authorization form:
(Note: you may require to send additional documents depending on your insurer's requirement)
Hospital will submit the pre-authorization form to the insurer. Insurer will review the documents and provide confirmation to the hospital to proceed with the cashless services. Normally, TPA issues a letter of confirmation within 3-6 hours provided all relevant documents are submitted.
Hospital sends the final bill to the insurer at the time of discharge.
Once the bill is confirmed, insurer makes payment directly to the hospital.
Here we help you to guide through the various claim process which you might go through with insurance companies. If in case you need further assistance, you may simply email us @ email@example.com