Cashless Hospital – What does it mean?

Cashless hospital means hospitals which are part of network hospitals of health insurance companies wherein the cost of the treatment is paid directly to the hospital. The insured does not need to pay cash to hospital for getting treatment in these hospitals.

Why is Cashless hospital network important?

Cashless facility is one of the most important services provided by health insurance companies. With cashless facility, in case of hospitalization, we don’t need to arrange for cash for treatment which can be quite expensive in some cases. Under cashless facility, at the time of hospitalization, we just need to inform the Insurer regarding the same and complete the required paperwork. Once approved the health insurance company would pay the bill directly to the hospital as per the terms of the policy.

Key points to remember for cashless hospital or cashless facility:

1. Check whether the hospital in which the patient is getting treatment is part of the cashless hospital network of the insurance company. You can find the list of cashless hospital network on the insurance company website.
2. If the hospitalization is a planned treatment or surgery, inform the insurance company before getting hospitalized. This process is known as getting pre-authorization. If it’s an unplanned hospitalization, due to any emergency, insurance company needs to be informed within 24 hours of hospitalization. Hospitals have defined processes for both planned and unplanned treatment, and they will assist you through the TPA desk available at the hospital.
3. Cashless facility does not mean that total hospital bill will be paid by the insurance company. Check the limits regarding room rent, room type etc before getting admitted. The final amount will only be paid as per the terms of health insurance policy.
4. For every hospitalization, the bill for some of the items are not paid by insurance companies. Such items known as consumables and non-payable items. The bill for these items need to be paid by the insured themselves. Few health insurance policies cover these costs through add on covers. Check if your health insurance policy has these add-on covers or not.
5. At the time of hospitalization, the hospital will ask for some advance amount to cover the part of the bill which would normally not be paid by the insurer. This advance is returned after deducting bill for non-payable items. This amount is usually credited to the bank account within 3-5 days of getting discharged.