The popularity of AYUSH treatments is growing exponentially in India, and people are now embracing these ancient methods alongside allopathy. However, when it comes to health insurance claims, admission to an AYUSH hospital often presents significant challenges. Insurance companies often reject claims, leaving the patient and family with an unbearable financial burden. This stress can be mitigated with proper information and proper preparation.
4 Main Reasons for AYUSH Claim Rejection
These are four key reasons why AYUSH treatment claims may be rejected:
Not an Accredited Hospital
Insurance companies only accept coverage at AYUSH hospitals that are fully accredited by the government or a relevant authority, such as the National Accreditation Board (NABH). Treatment at an unaccredited center will result in a claim rejection.
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Minimum Inpatient Period Not Completed
According to your policy terms, many plans require at least 24 hours of hospitalization to qualify for coverage. Ignoring this requirement in the case of AYUSH coverage could result in a claim being rejected.
Apparent Lack of AYUSH Coverage in the Policy
Not all health insurance plans automatically cover AYUSH treatment. When purchasing a policy, it’s important to ensure that your specific policy clearly includes AYUSH coverage and its maximum limit.
Lack of Documentation
A claim may be stalled if you don’t have accurate medical reports, accurate hospital documents, payment bills, and a discharge summary. It’s essential to preserve all treatment-related documents.
How to Increase the Chances of Claim Approval
You should take these strategic steps to ensure the success of your AYUSH claim. When purchasing an insurance policy, consider whether the policy includes AYUSH coverage. If not, consider adding a rider or purchasing a better policy. Always choose a government or NABH-accredited AYUSH hospital for treatment. Prefer a hospital over a small clinic.
Keep all documents related to your admission and treatment safe and submit them to the insurance company on time. The discharge summary and doctor’s notes are crucial. Read the policy terms carefully and strictly adhere to the minimum hospitalization period.
Why is AYUSH treatment essential
Many families choose AYUSH treatment because it is convenient and reliable. However, when a claim is rejected, the financial pressure increases significantly, and the patient faces additional mental stress. With the right information and proper preparation, you can reduce this stress and receive a full claim for your traditional treatment.
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