What Is A Network Hospital In Health Insurance?

At the times of the global pandemic it has been very well understood by the people that having a financial backup plan for medical expenses is important as there is a rapid rise in inflation in the health sector. Health insurance policies provide financial aid to the customers at an affordable price and offer extensive coverage to them under their plans. The coverage of the health insurance plans are customizable according to the needs of the customers and additional covers can be added to enhance the existing health insurance cover. Cashless and reimbursement claim settlement options are provided to the policyholders to choose from based on their choices.

Cashless claim can be availed only at the network hospital of the insurer while reimbursement claim can be made at any hospital of your choice. Both the types of claim settling processes have their own pros and cons, but the choice depends on the policyholder. Therefore, it is important for the customers to analyze their requirements accordingly. A health card is issued by the insurer to the policyholders, using which cashless claims can be made at the network hospitals which are linked with the health insurance company.

About Network Hospitals

Network hospitals are hospitals that are linked with a health insurance firm and they provide cashless claim benefits to the policyholders of the insurance company. After producing a health card issued by the insurer to the customers, the policyholder can avail the cashless claim benefits at the hospital. Each health insurance provider has a huge network of hospitals, as it is one of the factors that influences the choice of the customers while looking for a health insurance company. Seeking treatment at the network hospital of the insurance company enables the policyholder to avail the cashless claim benefits.

Must Read: Things to Consider About Cashless Network Hospitals in India

About Cashless Claim Benefits

Cashless claim benefits or cashless claim settlement process can only be availed by the policyholders at the network hospitals of the insurer. Under this claiming process, the medical dues incurred due to medical treatment at the network hospital, are cleared by the insurer directly with the hospital without involving the customer or any TPA. It makes the whole claim settlement process quick, smooth, and hassle-free for the customers and under this process, the customers do not have to pay a penny from their pockets. Some of its essential features for the policyholders include:

• It provides benefits like daycare procedures, room rents, hospitalization costs, etc. to the customers.
• It can be availed only at the network hospital of the insurer on producing the health card at the hospital desk.
• It takes less time to settle the medical dues of the customer when compared to other types of claim settlement process.

You can go for reimbursement claim only in case of unavoidable and emergency hospitalization, otherwise it is highly beneficial to go for cashless claim as in this case you don't have to pay any amount from your pocket. While, in case of reimbursement claim you must clear the medical dues yourself and then later the amount will be reimbursed in your registered bank account.

How To Find Network Hospitals?

The list of the nearby network hospitals is usually provided with the policy related documents. To look for more network hospitals of a specified health insurance provider you can visit their official website. More details regarding the claim settlement process can be looked for within the policy terms which the customer must read properly during the 15 day free-look period provided by the health insurance provider. Different health insurance companies have a different network of hospitals and therefore, you must know about the nearby network hospitals of your health insurance provider in case of a medical emergency.

Conclusion

You must inform your health insurance provider or TPA about the hospitalization as soon as possible to avoid any delays in the claim settlement process. You must carefully read the policy papers to avoid inconvenience at the time of the claim settlement process.

Also Read: 4 Differences Between Network And Non-Network Hospitals

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.