A Comprehensive Guide To The List Of Network Hospitals In India

Health insurance has become a necessity due to a significant surge in medical expenses. It works as a financial safety net during challenging times of medical crisis. Moreover, with the cashless facility, you can avail quality treatment without worrying about arranging money at the last moment.

Insurance companies offer a choice of hospitals in their network hospital list so you can get cashless treatment without paying money from your pocket. 

Read the following sections to know more about network hospitals and their benefits.

Things You Should Know about a Network Hospital

Every health insurance company has agreements with several hospitals to provide cashless treatment to its policyholders. These are called network hospitals and are an integral part of your health insurance policy.

Depending on the policy, your medical insurance will provide cashless cover for hospital fees and expenses incurred before and after hospitalisation. This works only when you get treatment from a network hospital. Therefore, it is vital that you take note of the health insurance network hospitals in your vicinity. 

How Does a Network Hospital Work?

Mentioned below are the points you should know to have a better understanding of how network hospitals work:

1. A health insurance company checks the efficiency and expertise of medical services provided before collaborating with a hospital. 
2. Following this, they prepare a network hospital list and provide it to the policyholders. 
3. This list changes from time to time depending on the quality of service provided by these hospitals. 
4. Individuals covered under cashless insurance will have to submit a form to the Third Party Administrator (TPA) before getting hospitalised. 
5. In case of an emergency, the claim process can be started 24 hours after hospitalisation.
6. The insurance company will cover the expenses mentioned in the insurance policy. You will only have to pay for services that the policy does not cover. 

Differences between Network Hospitals and Non-Network Hospitals

A network hospital is registered under an insurer’s list of hospitals that provide cashless treatment. When getting treatment from a network hospital, you have to contact the TPA to get a letter of authorization. The insurance company will then bear the expenses so that you do not have to spend money from your savings.

Unlike network hospitals, non-network hospitals are not registered under the network hospital list of health insurance companies. So, if you get admitted to a non-network hospital, you have to pay the bills from your pocket. 

Post-discharge, you have to submit the required documents. This involves a lengthy process of compiling and filing paperwork. The insurer will approve the expenses he/she finds reasonable. After a few days, the patient will receive the refunded amount. 

Pre-existing Disease List in Health Insurance

An individual suffering from a medical condition before purchasing a health insurance policy is said to have a pre-existing disease (PED). It is rather difficult to claim health insurance for PEDs. Policyholders have to undergo a waiting period of 2-4 years to get coverage for a specified ailment. 

On 10 February 2020, the Insurance Regulator and Development Authority of India (IRDAI) made significant amendments to the definition of pre-existing diseases.

As per the new clause, individuals who had their conditions diagnosed within three months of purchasing a health plan must be covered. Their conditions need to be registered in the pre-existing disease list.

Now your insurance policy can cover diseases such as asthma, diabetes, high blood pressure, thyroid, cancer, and more.  

Benefits of Availing Treatment at Network Hospitals 

In the present times, the importance of network hospitals has increased to a great extent. Given are some of the benefits of getting treatment at network hospitals. 

1. With network hospitals, you do not have to worry about losing valuable time. 

2. Your health insurance provider will cover all the medical expenses under the specified terms and conditions of the policy. 

3. Extensive bills will not weigh you down from getting quality treatment. Refer to your network hospital list to find a cashless hospital near your residence. 

How to Make a Cashless Claim at Your Nearby Network Hospital?

Here is how you can make a cashless claim following a few easy steps:

Planned hospitalisation

1. Find the nearest network hospital from the list.
2. Download the pre-authorisation form from the TPA’s website. You can also find it in the network hospital’s TPA counter.
3. Fill up the form and submit it to the insurer of your chosen network hospital.
4. You will receive approval with the coverage details. 
5. Present your health insurance card or your policy number on the day of hospitalisation. Submit your authorization form along with it. 
6. Make sure that you submit the form within the time period of validity.

Emergency treatment

1. Fill up and submit the pre-authorisation form within 24 hours of hospitalisation.
2. The insurance desk stationed at the hospital will send your form across.
3. The insurer will likely approve your claim within a few hours.
4. Ideally, you should wait for the TPA’s approval. However, in case of urgency, you can pay the bills at that moment. Later, you can apply for reimbursement.

Final Word

It is advisable to keep a network hospital list close for reference in case you need to get hospitalised urgently. With cashless claims, you can get treatment easier and without much hassle. Get yourself health insurance from  Navi App and free yourself from the burden of hefty hospital bills and concentrate on your recovery.  

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