Hyderabad : Insurance penetration in our country is very low. The main reason for this is a lack of proper understanding. There are many policies to provide financial protection to an individual in case of unexpected accidents. While taking health insurance, it is always better to go for a cashless claim. How to use it? It is necessary to know what precautions are needed to avoid trouble.
Claims in those health insurance policies are generally of two types. The first is to get treatment in hospitals identified by the insurance company. This does not incur any cost to the policyholder. This is called cashless treatment. The hospital pays the expenses up to the policy value. The second method involves paying the cost of treatment upfront and recovering the costs later.
In case of hospitalization, search for your nearest network hospital. Inform the insurance company once you get there. Carry your health insurance identification card or your health insurance policy document while visiting the hospital. Government-issued photo identity card is mandatory.
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Usually, every hospital has a separate department for insurance policies. They will assist you fully in your claim process. Some hospitals also have representatives from the insurance company or Third Party Administrator (TPA).
Necessary documents have to be submitted, the application signed and sent to the insurance company along with medical reports. After checking all the details, the insurance company will send a preliminary approval. The insurance company sends approvals step by step while the treatment continues in the hospital. The hospital pays the total cost at the time of completion of treatment.
Sometimes along with the insurance policy, policyholders may also have to pay some amount on their own. There are some key points to keep in mind to avail of cashless treatment. Note that a cashless solution is available only in the network hospitals. Check how much room rent and other treatments are covered in the policy.
Usually, the insurance policy has a provision of such a percentage of room rent. Try to stay in the same room as the room rent is paid according to the policy. If it is too much, it will have to be borne by hand. Do not forget that even if we pay the room rent difference, there are additional costs associated with the room rent.
Inform the hospital about the riders and top-up policies attached to the insurance policy. Ask the insurance company and get clear information. If your bill exceeds the basic policy, a top-up is useful.
