{"id":3397,"date":"2023-09-19T18:02:24","date_gmt":"2023-09-19T12:32:24","guid":{"rendered":"https:\/\/www.insurancesamadhan.com\/blog\/?p=3397"},"modified":"2023-09-19T18:04:56","modified_gmt":"2023-09-19T12:34:56","slug":"what-you-need-to-know-about-cashless-health-insurance-claims","status":"publish","type":"post","link":"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/","title":{"rendered":"What You Need to Know About Cashless Health Insurance Claims"},"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\/what-you-need-to-know-about-cashless-health-insurance-claims\/#OVERVIEW\" >OVERVIEW<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/#TYPES_OF_HEALTH_INSURANCE_CLAIMS_FILING\" >TYPES OF HEALTH INSURANCE CLAIMS FILING<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/#THE_PROCESS_OF_TAKING_CASHLESS_CLAIM_FACILITY\" >THE PROCESS OF TAKING CASHLESS CLAIM FACILITY<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/#THE_BENEFITS_OF_THE_CASHLESS_MODE\" >THE BENEFITS OF THE CASHLESS MODE<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/#CONCLUSION\" >CONCLUSION<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"OVERVIEW\"><\/span><b>OVERVIEW<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">What would you say if I told you that a guy named Ramesh bought a scooter but instead of riding it, he always used to drag it manually? Sounds a little strange right?<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">In this blog, we will discuss how most of the people can make their lives a lot easier when it comes to health insurance claims.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medical science has increased the longevity of our lives but that has come with a cost and post COVID, the over costs of medical treatment have gone up. With such an increase in health issues and costs of treatment, another thing which has gone up is the ICR of the insurance companies i.e. Incurred Claims Ratio. ICR is basically the total amount of claims paid against the total amount of premiums collected by an insurer.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In order to control this IC, insurance companies tie up with hospitals at discounted rates and promote cashless treatments across all major cities.<\/span><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"TYPES_OF_HEALTH_INSURANCE_CLAIMS_FILING\"><\/span><b>TYPES OF HEALTH INSURANCE CLAIMS FILING<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>CASHLESS MODE:<\/b><span style=\"font-weight: 400;\"> Cashless mode is like Ramesh riding the scooter. See, most of the insurance companies have a tie up with a lot of hospitals and they have pre-decided on the rates for various treatments. In this mode, the insured has to ensure that he\/she is admitted in a PPN hospital i.e. preferred provider network hospital and provide them with your policy details. It is then the task of their TPA desk to get both preauthorization and final claim approval from your insurance company.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>REIMBURSEMENT MODE:<\/b><span style=\"font-weight: 400;\"> For all claims in which an insured does not take the cashless treatments, he\/she must file a reimbursement claim along with all the medical documents and a claim form. In this, the insured pays upfront to the hospital and must wait for a few days to get his claim amount back.<\/span><\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"THE_PROCESS_OF_TAKING_CASHLESS_CLAIM_FACILITY\"><\/span><b>THE PROCESS OF TAKING CASHLESS CLAIM FACILITY<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The first step is to find out the hospitals which are on the CASHLESS panel.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Intimation to the insurance company and admission<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Applying for the preauthorization from the insurer which is generally done by the TPA desk.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Getting the treatment done and applying for final approval before discharge.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Usually, no additional payment is required other than consumables deducted by the insurer.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">In case your cashless claim is rejected, you must apply the same as a reimbursement claim<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"THE_BENEFITS_OF_THE_CASHLESS_MODE\"><\/span><b>THE BENEFITS OF THE CASHLESS MODE<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Easy on Pocket: <\/b><span style=\"font-weight: 400;\">No payment is to be made by the insured as the hospital will receive the claim amount directly from the insurer.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Saves time:<\/b><span style=\"font-weight: 400;\"> As the claim is cashless, save the insured\u2019s time to fill forms and apply manually.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Lower Wait time: <\/b><span style=\"font-weight: 400;\">Faster claim processing as the hospital is on network and aware of the process.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Quality Services: <\/b><span style=\"font-weight: 400;\">Better facilities as the insurer ensures a minimum quality and certification criteria before empaneling the hospital.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Guard of emergency: <\/b><span style=\"font-weight: 400;\">In medical emergencies, cashless acts as a life saver as insured might not have liquid amounts for treatment all the time.<\/span><\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-3398\" src=\"https:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims.jpg\" alt=\"Cashless Health Insurance\" width=\"1920\" height=\"1080\" srcset=\"http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims.jpg 1920w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims-300x169.jpg 300w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims-1024x576.jpg 1024w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims-150x84.jpg 150w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims-768x432.jpg 768w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/09\/What-You-Need-to-Know-About-Cashless-Health-Insurance-Claims-1536x864.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<h2><span class=\"ez-toc-section\" id=\"CONCLUSION\"><\/span><b>CONCLUSION<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Cashless health insurance claims are a blessing for policyholders, offering convenience and peace of mind during medical treatments. Reimbursements should only be applied when cashless is not available or rejected. An insured should always maintain a list of network hospitals in the vicinity of his home and work.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The true essence of health insurance is a cashless claim wherein the insured can get treated without any hassle and payments out of pocket.<\/span><\/p>\n<p><strong>By Chirag Nihalani &#8211; General Manager\u00a0<\/strong><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><strong>Click here<\/strong><\/a>\u00a0to register your complaint with Insurance Samadhan<\/p>\n<p>You can also<\/p>\n<p>Visit our website:\u00a0<a href=\"https:\/\/www.insurancesamadhan.com\/\">insurancesamadhan.com<\/a><\/p>\n<p>Call us on +91 9513631312<\/p>\n<p>WhatsApp:\u00a0<a href=\"https:\/\/api.whatsapp.com\/send?phone=+919910998252&amp;text=Hi\">\u00a09910998252<\/a><\/p>\n<p>Mail us at\u00a0<a href=\"mailto:corporate@insurancesamadhan.com\">corporate@insurancesamadhan.com<\/a><\/p>\n<p><script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\/\",\n  \"@type\": \"Article\",\n  \"mainEntityOfPage\": {\n    \"@type\": \"WebPage\",\n    \"@id\": \"https:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/\"\n  },\n  \"headline\": \"What You Need to Know About Cashless Health Insurance Claims\",\n  \"description\": \"Explore the ease of cashless health insurance claims in our blog. 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Sounds a little strange right? In this blog, we will discuss&hellip; <a href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-you-need-to-know-about-cashless-health-insurance-claims\/\" class=\"more-link\">Continue Reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":14,"featured_media":3399,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[20,322],"tags":[],"class_list":["post-3397","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insurance-claim","category-insurance-problem"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What You Need to Know About Cashless Health Insurance Claims - Insurance Samadhan<\/title>\n<meta name=\"description\" content=\"Explore the ease of cashless health insurance claims in our blog. 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