Cashless Claim Vs Reimbursement Claim in Health Insurance: All You Need to Know

Posted on: Mar 1, 2022 | | Written by:

Cashless Claim Vs Reimbursement Claim in Health Insurance: All You Need to Know

Published on March 1, 2022. EST READ TIME: 3 minutes

In reality, our healthalso goes through ups and downs and all of a sudden you may come face to face with an unexpected situation. To deal with such unwanted situations, purchasing health insurance is the best solution and it also provides you the financial support during such emergencies. While there are many insurance companies that offer various policies that would suit the current financial struggles of people but it is your responsibility to choose the right plan that would serve you and your loved ones the best in sudden medical emergencies. Apart from purchasing a health insurance, one must be aware about the claim process as well. Here are the things you need to know

How to File a Health Insurance Claim?

• Collect all your itemized receipts from the hospital or from your doctor as these will be needed to assess the expenditure incurred.

• Fill up your claim form. This can be submitted online or sent to the insurance company by post.

• Keep a copy of the documents in case the insurance company asks for the originals.

• Contact the insurance company and let them know that you have filed a claim. Follow up regularly and also ask them about the expected time for payment.

Types of Health Insurance Claims

There are two types of health insurance claims and it’s important that you do not delay claiming your health insurance:

1. Cashless Treatment:

In this case, you will have to inform the insurer about your pre-planned hospitalization of 48 or 72 hours in advance. In case, you have to get admitted in emergency, you need to inform you insurer within 24 hours after hospitalization.

• You can visit the hospital and show your insurance card along with a valid ID proof.

• You might also need to fill in the pre-authorization form and send it to the insurer.

• Your insurer will then send an authorization to the hospital to begin the treatment and you can enjoy a cashless one.

2. Reimbursement Claim:

Under this facility, the insured person has to file for a claim with the insurer to get back the amount spent by him/her on the treatment covered in the insurance plan. This has to be filed within 15 days of being discharged from the hospital.

• Submit a claim form along with a photo ID proof.

• You will also need other documents like – final bill from the hospital, itemized receipts, payment receipts, breakup of the hospital bill, discharge summary, operation theatre notes, ambulance receipt, certificate from the attending doctor, medical reports and prescriptions, medicine bills and final police report, if applicable.

Conclusion

We know how a healthinsurancecan help us tackle rising medical expenses. Similarly, a little information about how to file an insurance claim, when to file and where to file, can also help us lessen our burden during emergencies. If you delay in filing your insurance claim, the insurer might refuse to accept your proposal completely. So, whenever you buy a health insurance policy, make sure you and your family members are well aware of the terms and conditions for filing the claims.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

What is Cashless Health Insurance – Benefits & Process

How Does Cashless Claims Work?

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