How a Cashless hospitalization works?
If your policy covers surgery and hospitalization, then walk into a network hospital present your card or card number and get treated without paying a single rupee. If it is not an emergency and is an already fixed appointment at the hospital then inform the Third Party Administrators (TPA) and get it pre- authorised. A TPA is an intermediate body that liaises between the hospital and the insurance agent verifying policies and giving clearance for cashless hospitalization to be processed on behalf of the insurer. In emergencies, TPA takes no more than six hours for cash settlement and in other cases no more than four days for the same. The insured needs to always check which hospitals, treatments, illnesses and surgeries are covered under the policy. …show more content…
Even under emergencies, if you want to take the insured to a nearby hospital to save time, with cashless hospitalization this is not a possibility. While other insurance policies, allow the insured to go to any hospital and then later claim the money. Ignorance of the insured on how the policy works creates tension for the insured and rejection by the TPA. TPA can sometime give the insured and the insurer a hard time rejecting the policy, making them run around for reimbursement and delaying the cash settlement. Hospitals also have no uniformity in the charges creating