Simple Steps To Make Cashless And Reimbursement Claims In Health Insurance

Health insurance plans bought by the policyholders must be comprehensive and should meet their requirements at an affordable price. Health insurance plans come with features like pre and post hospitalization expenses, room rents, ambulance charges, medication costs, domiciliary expenses, inpatient costs, and a lot more. Health insurance policies come with a waiting period during which the policyholders cannot avail the benefits of the health insurance plan. The waiting period of the policy is specified by the insurer depending on the medical condition. Policyholders can avail of the benefits of their plan at the time of the claim settlement process. The claim settlement process is the most important process of a health insurance plan as it enables the policyholders to receive quality treatment without worrying about monetary constraints. 

A lot of procedures are involved during the claim settlement process of a health insurance plan. For a smooth and hassle free claim settlement experience, the policyholders must follow certain key points like keeping the documents handy, reading the policy terms, informing the insurer on time, etc. There are two different types of claim settlement processes namely cashless claim settlement and reimbursement claim settlement process. The policyholders can approach a particular claim settlement procedure based on their choices, financial budget, etc. 

About Cashless Claim Settlement Process

The cashless claim settlement process is the claim settlement process under which the policyholders can receive treatment at the network hospital of the insurer without paying a penny from their pockets. It is mandatory to seek hospitalization in the network hospitals linked with the health insurance provider to avail of the cashless claims. Under this claim, the insurer directly clears the medical dues of the policyholders with the hospital without involving any third party. 

Let us look at the steps involved in getting cashless claim settlement benefits under a health insurance plan at the time of medical treatment: 

1. Inform your health insurance provider about the hospitalization as early as possible. In case of planned hospitalization, the policyholders can inform days ahead of the treatment while in case of unplanned hospitalization, one must inform the insurer as soon as possible to kick start the claiming process. 
2. Get hospitalized in one of the network hospitals linked with the health insurance provider. You can get the list of the nearby network hospitals of the insurer on the internet or the policy-related documents. 
3. Produce your health ID card at the hospital desk to receive a cashless claim. This health card is generally issued by the health insurance provider to the policyholder. 
4. Submit the duly filled and signed claim form along with the other mentioned documents to the insurer. 
5. Seek hospitalization and receive your treatment without any worries as the medical bill will be cleared directly by the policyholder without any hassles. 

About Reimbursement Claim Settlement Process 

The reimbursement claim settlement process can be avail by the policyholders after receiving treatment at any hospital of their choice. Under this claim process, the medical dues are borne by the policyholders initially and later, the amount is reimbursed in their registered bank account. It is advisable to go for this claim process only when there are no monetary constraints. 

Following are the steps involved under the reimbursement claim settlement process: 

1. Inform your health insurance provider about the hospitalization as early as possible. In case of planned hospitalization, the policyholders can inform days ahead of the treatment while in case of unplanned hospitalization, one must inform the insurer as soon as possible to kick start the claiming process.
2. Get hospitalized in any hospital of your choice and seek treatment. Pay the medical dues before discharging.  
3. Collect all the documents like the diagnosis reports, lab reports, discharge papers, medication bills, invoices, etc. and submit them along with the duly filled claim form. 
4. After the verification of your documents and approval of your claim request, the amount will be reimbursed into the bank account of the policyholder. 

Conclusion 

You can go along with any of the above-mentioned claim settlement procedures depending on your financial budget, medical condition, etc. However, it is wise to choose cashless claim benefits as under this, the policyholders need not pay any amount for their hospitalization and treatment.  

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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.