What is Cashless Hospitalization?

How many times do you remember getting a call from a friend or a relative telling about an emergency hospitalization and need of cash? You rush, many times in the middle of night to the nearest ATM and retrieve thousands of rupees that are required for getting yourself admitted in todays good quality hospitals. Cashless Service is a facility which is designed specifically to avoid these- panicky and tensed moments during hospitalizations.

What is Cashless Hospitalization?

In Cashless Service, when you get hospitalized with a network hospital, you do not have to settle the bill with the hospital. The Insurance Company represented by the TPA, co-ordinates with the hospital and settles the bill.

How does it function?

Health insurance companies make tie-ups with hospitals after negotiating their rates and checking their quality. These hospitals are called as Network Hospitals; Cashless service is available only in these hospitals. To know which hospitals are in your health insurance providers network, check the name of your TPA in the policy and visit its website or call their toll free number.

TPA or Third Party Administrators are the representatives of the health insurance companies who are responsible for settling the claims both reimbursement claims as well as cashless claims. It is the TPAs who have to approve your request for cashless and provide the service.

Pre authorization form is the form that you get at the insurance desk in the hospital or in the website of the TPA, after being duly filled by the patient and the hospitals representatives, it is sent to the TPA which decides to approve or reject the claim.

Now about the process for Cashless Facility:

Planned hospitalization: In a planned hospitalization, you have a recommendation for hospitalization by your doctor and have time to decide which hospital to go to. You have to complete the formalities at least 3-4 days before you are hospitalized.

Emergency hospitalization: In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. You need to start the procedure for cashless facility within 24 hours of hospitalization.

What is not paid?

You may notice that even with the cashless service, there are some expenses that you will have to bear, these expenses are:

Why is the request for Cashless rejected?

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