{"id":1321,"date":"2022-05-09T10:36:28","date_gmt":"2022-05-09T05:06:28","guid":{"rendered":"https:\/\/www.insurancesamadhan.com\/blog\/?p=1321"},"modified":"2022-06-10T16:42:27","modified_gmt":"2022-06-10T11:12:27","slug":"how-to-file-medical-claim-at-the-hospital","status":"publish","type":"post","link":"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/","title":{"rendered":"how to file medical claim at the hospital?"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_76 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/#What_are_the_types_of_medical_insurance_claims\" >What are the types of medical insurance claims?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/#Cashless_Claim\" >Cashless Claim<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/#Planned_Admission\" >Planned Admission<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/#Emergency_Admission\" >Emergency Admission<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/#Reimbursement\" >Reimbursement<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<p>Manju Dhingra is an elderly lady and senior citizen whose only relative is her son. After her son moved to the US for better career prospects, she has challenges with managing many tasks. Her son is also worried about his mother and has recently got her one of the best medical insurance policies. She had gone to a hospital a few days ago and was diagnosed with appendicitis. Her appendix had to be surgically removed in an emergency procedure and thankfully the operation went well. Manju and her son are now wondering how to claim health insurance for these expenses.<\/p>\n<p>A medical insurance claim or health <a href=\"https:\/\/www.insurancesamadhan.com\/blog\/category\/insurance-claim\/\">insurance claim<\/a> is basically a request that the policyholder raises for the expenses incurred in the medical treatment. As the request is raised, the insurance provider verifies the claim and either settle the medical bills with the hospital or asks the policyholder to pay it from their pocket and later reimburses the amount to the insured. It totally depends upon the type of health insurance claim process that the policyholder has chosen. This writing will help many policyholders in answering the important question of, how to claim medical insurance.<\/p>\n<p><center><a href=\"https:\/\/www.insurancesamadhan.com\/register\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Get Resolutions for Insurance Complaints\" \/><\/a><\/center><\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_are_the_types_of_medical_insurance_claims\"><\/span><strong>What are the types of medical insurance claims?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main objective of any health insurance or medical claim policy is to provide financial support to the policyholders when needed. However, to get the coverage benefit from the insurer, the policyholders have to get either of the two services, which include:<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Cashless_Claim\"><\/span><strong>Cashless Claim <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In a cashless claim, the insured can get the required treatment at any network hospital of the insurance provider. While getting hospitalized, the insured must show his\/her cashless health card that was provided to them by the insurance company. The bill raised by the hospital will be directly settled by the insurer. There is no need for the policyholder to pay even a single penny. You need to know that the majority of the insurance providers approve cashless treatment within four hours of admission at the network hospital.<\/p>\n<p>Cashless claim settlement is available in two ways. And those are mentioned herein below:<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Planned_Admission\"><\/span><strong>Planned Admission<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>You have to choose a hospital from the list of network hospitals which is mentioned in the insurance document<\/li>\n<li>You would be required to inform the Third-Party Administrator (TPA) at least three days before being admitted to the hospital and provide a membership number<\/li>\n<li>You will then have to fill out a cashless request form which you will find at the hospital<\/li>\n<li>Now at the TPA counter, you have to submit the form as well as medical records<\/li>\n<li>All the submitted documents will be inspected by TPA<\/li>\n<li>Once all the documents are approved, the hospital bills will be settled by the insurance company. However, the only things that you have to pay for are attendant charges, phone charges, food, etc.<\/li>\n<li>If in any case, TPA does not approve it, you can file for reimbursement.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Emergency_Admission\"><\/span><strong>Emergency Admission<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>If it is an emergency admission, you can inform the Third-Party Administrator and provide them with a membership number<\/li>\n<li>You have to then fill in the cashless form at the hospital, which has to be certified by a doctor<\/li>\n<li>Now send the form as well as the medical records to the TPA<\/li>\n<li>If the TPA sanctions the cashless facility, the insurance provider will directly settle the bills<\/li>\n<li>If it is not approved, you can look for reimbursement<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Reimbursement\"><\/span><strong>Reimbursement<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>For reimbursement, you would be required to pay for the treatment from your pocket, and then you have to file a claim for the reimbursement from the insurance company. As you try to claim, you have to submit the bills and also showcase the other records of the funds that were needed for hospitalization as well as the treatment. The insurance company verifies all the submitted bills and then credits the amount to the bank account of the policyholder.<\/p>\n<p>If in case your cashless claim request is rejected somehow, or any of your family members is getting treatment at a non-network hospital, you can apply for a reimbursement. However, make sure that you apply for it within seven days of the discharge of the patient. Here are the medical insurance claims processing steps that you have to follow.<\/p>\n<p><center><a href=\"https:\/\/www.insurancesamadhan.com\/register\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Get Resolutions for Insurance Complaints\" \/><\/a><\/center><\/p>\n<ul>\n<li>You first have to contact the insurance company from which you have bought your <a href=\"https:\/\/www.insurancesamadhan.com\/blog\/category\/health-insurance\/\">health insurance<\/a> policy. You can call on the toll-free number and provide your membership number<\/li>\n<li>After you have settled all the medical bills, you have to submit your bills, discharge summary, prescriptions, and other important documents that you want to be reimbursed<\/li>\n<li>You then have to download and fill out the reimbursement form that is available on the website of your insurance provider<\/li>\n<li>Now you have to submit the form as well as the medical records to your insurer<\/li>\n<li>As the claim is approved, they will disburse a cheque. The usual time taken for the process is 20 days from the date of receiving the documents.<\/li>\n<\/ul>\n<p>While you are doing all these, make sure the form is duly filled. And in case you find any hindrance in the process, you can get in touch with Insurance Samadhan at your convenience. You can also refer to the sample letter to an insurance company for medical claims to make sure that you follow the right format and include all relevant details.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Manju Dhingra is an elderly lady and senior citizen whose only relative is her son. After her son moved to the US for better career prospects, she has challenges with managing many tasks. Her son is also worried about his&hellip; <a href=\"http:\/\/www.insurancesamadhan.com\/blog\/how-to-file-medical-claim-at-the-hospital\/\" class=\"more-link\">Continue Reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":1322,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[3],"tags":[],"class_list":["post-1321","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-insurance"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How To File Medical Claim At The Hospital | Insurance Samadhan<\/title>\n<meta name=\"description\" content=\"If you have a medical insurance and you want to know how you can claim your benefits then read this blog to get the full information.\" \/>\n<meta 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