Health Insurance: Any person may face a medical emergency in life. Hospitalization may be required many times due to accidents, heart attacks, prolonged illness, etc. After being admitted to a private hospital, the hospital bill increases rapidly. It is very important to take health insurance so that the patient or his family does not have to bear the burden of this bill. But, just taking a policy is not enough, it is also important to follow the right process at the right time.
Understand your policy
First of all, find out if the new changes made in your health insurance policy have been updated or not. In some policies, there may be a need to upgrade to provide cashless treatment facilities in non-network hospitals. Get information about the things not included in the policy as well as its limits. This will save you from unexpected expenses.
Pre-authorization process
Now you can get cashless treatment in non-network hospitals as well, but pre-authorization is necessary for this too. This is important to avoid spending money. Before or immediately after hospitalization, you or the hospital should inform the concerned insurance company, which will review the treatment plan and estimated cost. This process will help you be financially prepared.
What to do for pre-authorization
First of all, send a valid identity card, medical reports, and estimated cost of treatment at the hospital to the insurance company along with the health insurance card. Then wait for its approval. Usually, insurance companies give their response in this regard within an hour. This quick response will give you peace of mind.
Required documents
Several documents are required to properly proceed with the pre-authorization process and claim. These should include a doctor’s prescription under the health insurance card or policy details, a valid identity card (PAN card, Aadhaar card, etc.), medical reports, as well as reports of all tests. The assessment of the treatment by the hospital should also be included. These documents will facilitate your claim process.
Emergency
In an emergency, some insurance companies provide post-treatment authorization. It provides the facility to get immediate treatment as well as get approval later. For this too, the insurance company should be informed within 24 hours of hospitalization. This facility will help you ensure timely treatment.
Hospital TPA Desk
Usually, most hospitals have a third-party administrator desk or TPA desk. This desk acts as an intermediary between you, the hospital, and the insurance company. Not only this, the TPA desk provides free service of getting treatment as well as processing the insurance claim based on your health policy. From here you can get information about what expenses will be included in the claim and how much money you will have to spend. This desk makes your claim process easier.