Difference Between Network And Non-Network Hospitals

The most essential part of having a health insurance policy is claiming the policy at the time of a medical emergency. A health insurance cover provides financial aid to the customers at the time of hospitalization. The health insurance cover comes with a lot of benefits like hospitalization expenses, room rents, ambulance charges, domiciliary expenses, inpatient costs, etc. There are various choices in a health insurance cover from different health insurance providers. Therefore, the customers must analyze their requirements before investing in a particular health insurance cover. You must consider various factors like your age, medical history, pre-existing diseases, financial budget, etc. while looking for a suitable health insurance plan.

When claiming a health insurance policy, being a customer you get to choose between the cashless claim settlement process and the reimbursement claim settlement process. Cashless claims can be availed only at the network hospital of the insurer while reimbursement claims can be made at any hospital of the customer's choice. Network hospitals are the ones that are linked with the health insurance companies and insurance providers clear the medical dues of the customers directly with the network hospitals without involving the customer. It is pocket friendly and quick as it clears the medical expenditures without any hassles.

About Network Hospitals

Network hospitals are hospitals that are affiliated with a health insurance company and they offer cashless claim benefits to the insurer's policyholders. The policyholder can use the cashless claim benefits at the hospital after presenting a health card supplied by the insurer to the client. As one of the considerations, each health insurance company has a large network of hospitals. Network hospitals are one of the factors that influences the choice of the customers when choosing a health insurance provider. Mostly the customers should seek treatment at the network hospitals as the medical dues at these hospitals are cleared directly by the insurer without involving the policyholder, thus making the whole process smooth, quick, and hassle-free.

Must Read: What Is A Network Hospital In Health Insurance?

About Non-Network Hospitals

Non-network hospitals are any regular hospitals which do not have any links with the health insurance company. You can make only reimbursement claims at the non-network hospitals where the customers have to clear the medical dues before discharging and later after some days the amount is reimbursed into their registered bank account. A person who has a financial budget of incurring the medical expenses at the time of discharge or people with emergency or unavoidable medical conditions can go for the non-network hospitals, otherwise it is advisable to file cashless claims as they are quick and hassle-free.

Major Differences Between Network And Non-Network Hospitals

Following are the factors on which the network and non-network hospitals differ from one another:

1. Formalities

At the non-network hospital, the policyholder has to go through a lot of formalities like paperwork, form submissions, etc., while in case of cashless claims at network hospitals the insurer directly clears the medical dues without much effort. Network hospitals settle the claims quicker than a non-network hospital.

2. Cash Payments

At the non-network hospitals, the policyholders have to file for reimbursement claims under which the medical dues have to be cleared by the policyholders initially, and later the amount is reimbursed in their registered bank accounts which can take 2 to 3 working days. While, under cashless claims at network hospitals, the medical dues are cleared by the insurers directly and the policyholders do not have to pay a single penny from their pockets.

3. Waiting Period

At the network hospitals, the claims are cleared hours after the request is filed with the insurer. As soon as the verification is done, the claim amount is availed and the dues are cleared at the network hospitals. However, non-network hospitals take 2 to 3 working days to avail the claim of the health insurance policy. The documents are submitted and verified by the insurer and the amount is transferred into the bank account of the insurer.

Conclusion

You must choose cashless claim benefits at network hospitals as it is quick and efficient but in case of unavoidable medical emergencies, you can go for non-network hospitals and file reimbursement claims.

Also Read: How Network Hospitals in Health Insurance Benefit You

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.