What is a Network Hospital in Health Insurance?
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Do I need to pay anything upfront? Will the insurance company deal with my hospital bills? These are the important questions you think about when buying health insurance. This is where the concept of a network hospital comes into play.
Network hospitals offer cashless medical care; policyholders only pay for non-medical expenses. Understand what a network hospital is and how it can help you during an emergency.
What is Network Hospital in Health Insurance?
Network hospitals are a set of pre-approved hospitals with which insurance companies have agreements to provide cashless hospitalisation to policyholders. It means policyholders can avail of cashless treatment at network hospitals.
The insurance company will directly settle hospital bills, allowing policyholders to focus on recovery rather than bear the financial burden.
Most insurance companies have network hospitals across India to ensure convenience and accessibility for policyholders.
How Do Network Hospitals Work for Individuals?
When policyholders get hospitalised for a health emergency in a network hospital, they get cashless hospitalisation. A policyholder or any family member must notify the insurer of the hospitalisation within 24 hours of admission.
Suppose Mr Paul, 52 years old, needs immediate hospitalisation for a particular surgery. He gets hospitalised, now:
- His family member carries the health insurance ID card and completes documentation, such as form-filling, within 24 hours of admission.
- After sharing health policy details and filling out the form, the hospital will start verification immediately.
- Once the insurer approves the claim, Mr Paul gets quality treatment without paying upfront at a network hospital.
He only has to pay a deductible amount. Mr Paul does not even have to submit invoices or bills to the insurance company. The insurer will pay the entire hospitalisation and treatment expenses as covered in the policy.
However, there is also a possibility that Mr Paul can claim reimbursement. But in that case, he has to pay the hospital bill out of his pocket after getting treatment at a network hospital.
- He has to follow a long process and wait a while.
- After getting discharged from the hospital, Mr Paul has to submit medical bills and other documents to the insurer.
- The insurer will evaluate and assess the documents, then settle the claim.
- Mr Paul gets a reimbursement for the entire treatment expense and hospital bill.
What are the Advantages of Choosing Network Hospitals?
1. Cashless Treatment
Choosing a network hospital allows policyholders cashless treatment and focuses on recovery. Policyholders do not have to worry about managing funds for treatment or an immediate financial burden.
2. Financial Protection with Quality Treatment
Treatments at network hospitals are more cost-efficient due to pre-negotiated rates and a cashless hospitalisation agreement with the insurer. It supports a broad safety margin and quality treatment accessibility in the rising medical costs.
3. Availability and Simplified Process
Network hospitals are often widely accessible and conveniently located across India. Even the claim and billing process is streamlined that reduces administrative tasks and paperwork and demand of paperwork.
Navigate your insurer's official website and check the network hospitals list in your health insurance. Besides that, you can contact them by email or phone. In case of a medical emergency, you forget to find network hospitals and a cashless facility, pay the bills on your own and claim reimbursement from your insurer.