How to Check Cashless Hospital Availability?

With rising healthcare costs, cashless hospitalisation has now become a preferred choice. It is used for almost the majority of health insurance claims in India. However, not every hospital offers this facility. Knowing how to check the availability of cashless hospitals can help prevent any last-minute stress during treatment.

Read on to learn more about checking cashless hospital availability.

What Does Cashless Hospitalisation Mean?

Cashless hospitalisation allows the insured person to get medical treatment at a network hospital without having to pay the full bill upfront. Instead, the insurance company directly covers it by paying the hospital after approval.

What are the Different Ways to Check Cashless Hospitalisation Availability?

1. Check Insurer's Official Website

Most of the health insurance companies maintain an updated list of network hospitals on their official websites. You can check there by entering details like city, PIN code or hospital name.

2. Use Insurer's Mobile App

Many insurers provide mobile applications with built-in network hospital locators. On these apps, you can see nearby cashless hospitals on your insurer's network with GPS.

3. Contact the Hospital Directly

You can also contact the TPA desk of the hospital directly to confirm whether they accept your specific insurer and policy. You can ask them whether they accept cashless treatment required for your specific procedure.

What are the Pre-Authorisation Requirements for Cashless Hospitalisation Claims?

A pre-authorisation is mandatory when going for a cashless hospitalisation. It allows the insurer to assess and approve the treatment costs in advance.

• For Planned Hospitalisation: You need to submit a pre-authorisation at least for a time of 48 hours before hospitalisation. The documents to submit with this claim are medical reports, the doctor's advice and the treatment cost estimation.

• For Emergency Hospitalisation: Insurers should be informed within 24 hours of hospitalisation. Generally, the hospitals assist in submitting pre-authorisation requests during emergencies.

What are Some Mistakes to Avoid When Using Cashless Hospitalisation?

● Incomplete or Incorrect Paperwork

Incomplete documentation is a frequent reason cashless claims get rejected or delayed. Both hospitals and insurers require accurate policy details and medical reports. For instance, even a minor mistake, such as providing incorrect ID numbers, can lead to denials and rejections.

Hence, it is ideal that you check the entered details thoroughly prior to submitting.

● Delaying Pre-Authorisation Requests

Waiting too long to submit a pre-authorisation request can also jeopardise your cashless claim approval. For planned treatments, insurers expect this request before admission. A late submission can delay or even lead to rejection of approval.

● Not Checking Whether Hospital is in Network

One of the most common mistakes is assuming that a hospital will offer cashless treatments. If a hospital is not on the insurer's network list, then the cashless request will be denied. Or you may also have to pay up front.

Final Words

Cashless hospitalisation reduces financial stress during any medical treatment. However, it works smoothly only when you are well-prepared. By checking the insurer's network hospital list and understanding pre-authorisation rules, you can get swift access to cashless healthcare.