All About Cashless Network Hospitals: Advantages, Limitations And Claim Process

Network hospitals associated with insurance companies offer cashless treatment benefits to policyholders. If an insured individual seeks treatment at any such hospital, he/she can do so without paying anything out of pocket.

Insurers provide a list of cashless hospitals to policyholders when they purchase a health insurance policy. Additionally, for the ‘cashless hospital near me’ searches, it is common for individuals to get a list of empanelled hospitals on their insurance company’s website. 

However, one should know how cashless hospitals work, their benefits and the claim process before availing of services. Following is a look at all such aspects. 

List of Cashless Network Hospitals in India

Also Read – https://navi.com/blog/pmjay-ayushman-bharat-yojana/ 

How do Cashless Network Hospitals Work?

Unlike other non-partner hospitals, cashless hospitals offer medical treatments for which insured individuals do not need to pay the expenses upfront. Instead, their health insurance provider will settle the costs of room rent, treatment, ambulance, admission charges and doctor’s fees directly with the concerned hospital.

Therefore, policyholders can get coverage up to the limit of the sum insured as per their insurance policy from the network hospitals. 

However, insured individuals need to inform the network hospital that their insurance policy covers cashless treatments before seeking treatment. After doing so, they need to furnish a few documents, including the health card issued by the insurance provider, to avail the cashless option. 

By searching for a ‘cashless hospital near me’, policyholders can get medical expenses covered without paying anything out of their pockets. 

Advantages of Getting Treatment from Cashless Network Hospitals

Take a look at the benefits of getting treatment from the aforementioned cashless hospital list:

Comprehensive cover for hospitalisation expenses

Arranging funds to pay medical bills can be difficult during unforeseen circumstances. However, obtaining health insurance and getting treatment from an insurer’s cashless network hospital can be convenient as it covers both planned and emergency hospitalisation expenses. A policyholder simply needs to inform his or her insurer before 24 hours of hospitalisation in case of emergencies and 48 hours during planned hospital treatment. 

Easy healthcare access

Several insurance providers have tie-ups with a list of hospitals across India. Therefore, policyholders can expect easy access to cashless treatments in their respective cities without any hassle. 

Affordability

While getting treatment from non-network hospitals, individuals need to pay their treatment costs out of their pockets. This way, they can end up paying a higher amount. Even if they opt for reimbursement from insurance companies, they would not be able to avail cashless facilities. On the contrary, if policyholders get treatment from network hospitals, they can avail a cashless claim for the actual treatment costs. Hence, this procedure of getting treatment guarantees affordability and convenience. 

How to Raise a Claim through Cashless Network Hospitals?

To raise a health claim via a cashless network hospital, follow the given steps:

• During planned hospitalisation, inform your insurance provider 48 hours before getting hospitalised to authorise the cashless facility. 
• In case of emergency hospitalisation, you must ensure to inform your insurer 24 hours prior to hospital admission. 
• Generally, insurance providers offer a health card to the insured members that can be used to get cashless medical treatment at any network hospital across India. 
• Now, you can get treatment from any network hospital without making any payment. 
• An insurer will send you the medical expenses details along with any co-payment clause or exclusions if applicable. In such a case, you will need to pay the co-payment amount first to avail cashless facility. 

After getting treatment, you must submit a few documents to the hospital management to avail cashless facility. These documents include identification proofs, policy documents and health cards. 

However, prior to hospital admission, make sure to search for ‘cashless hospital near me’ to check a list of network hospitals offering cashless facilities. 

Limitations of Cashless Network Hospital Services

Although cashless facility covers a number of treatments and procedures, there are a few exclusions as follows:

1. Hospitalisation due to wars, chemical reactions, weapons and radiation. 
2. Suicide attempts, self-injury resulting in hospitalisation. 
3. Hospitalisation resulting from consumption of alcohol or drugs. 
4. HIV/AIDS treatment. 
5. Mental disorders and congenital diseases. 
6. Cost of non-medical items such as spectacles, supplements, etc.

Reputed insurance providers like Navi offer comprehensive health benefits coverage from over 10,000 network hospitals across 400 locations with premiums starting as low as INR 241 per month. Download the Navi App and obtain cashless claims in under 20 minutes. 

Also Read – https://navi.com/blog/network-hospitals/ 

Final Word

Cashless network hospitals, thus, offer a host of benefits that help policyholders secure their finances every time they opt for medical treatment. Therefore, the next time you search for ‘cashless hospital near me’, make sure to go through the list properly, check the benefits offered and other details before choosing a network hospital to make an informed choice and not choose something in haste. 

Frequently Asked Questions

Do policyholders need to pay extra while availing cashless facility from a network hospital?

No. Insurance companies do not charge any additional amount for the cashless claim facility. However, policyholders must intimate the insurance company while getting admitted to a hospital to avail the benefits. 

Can I get a cashless facility from any hospital?

Not all hospitals have tie-ups with insurance companies. Therefore, it is vital to go through the insurer’s website to check the list of network hospitals before getting treatment. 

What happens if an insurance company does not have a cashless facility?

In case an insurance company does not have a cashless facility, policyholders can opt for reimbursement.

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