Insurance

Health Insurance – All About Preferred Provider Network Hospitals

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In the current era of increasing medical risks, a health insurance policy is not only an important investment, but also an important tool for protection. Hence, you have to be careful while choosing a plan. These tough times are not only psychologically challenging but also stressful on financial resources. In view of the rising costs of health care facilities, cashless health insurance plans can help.

By using the cashless facility, you do not have to worry about paying hospital bills. The only prerequisite is getting treatment in a network hospital. Network Hospital is an affiliate of an insurance company. This way, the payment for treatment at this medical facility will be paid directly by the insurance company on your behalf.

Health insurance payments are made by the insurer in one of two ways – Reimbursed or Cashless. You can buy health insurance plans online in either of two modes. Network hospitals are something that are part of the cashless claim process. Let’s dive deeper into the concept.

Network hospitals

Every insurance company creates a network of hospitals, clinics, and medical professionals. These medical institutions charge lesser fee from the policy holder of the insurance provider they are affiliated with. As a reward, these hospitals get more patients visiting them through the insurance company network.

Health insurance companies understand that the policyholder will eventually come to them with larger claims. This means that they will have to pay a substantial amount as reimbursement for the hospital bills that the policyholder paid. In response, they negotiate with hospitals to make the situation easier for them and make them part of their network.

Network hospitals charge less for a customer with a cashless health insurance plan compared to a reimbursement plan. In return, they benefit from the large number of policyholders coming to their hospital for treatment. * Standard T&C Apply

Difference between Network Hospitalization and Non-Network Hospitalization

In the case of network hospitalization, the patient is admitted or treated at one of the cashless insurance hospitals in the insurance company network. The patient can then submit a form to the TPA for a cashless claim. Once the cashless claim is approved, the patient can receive treatment and all costs will be borne directly by the insurance company. The patient is not required to submit any bills or documents and there is no waiting period. Only expenses not covered under the policy will be borne by the policyholder.

However, when a person is admitted to a hospital outside the insurance provider’s network, they have to pay for the entire treatment. Upon discharge, they may submit all documents and required reports to the insurance company. The insurance company will thoroughly examine all the documents and approve the claim if it everything checks out. The appropriate amount from the hospital bill they pay will be returned to the policyholder after 10-12 days. * Standard T&C Apply

If you have a cashless family health insurance policy, it makes sense to seek treatment at network hospital. Always have a list of the best health insurance cashless network hospitals ready in case you need to be rushed to the hospital. Consider going to a non-network hospital only in case of an emergency or when the necessary treatment is not available at any network hospital. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.

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