Health Insurance Claims
The health insurance tends to cover overall risk estimation of the health care. This includes test reports, hospital bed charges, food that comes under the health care benefits accordance to the insurance agreement. You can regulate the benefits by your insurance provider.
How Are You Going to Claim for the Health Insurance Policy??
You have to provide cashless card in network hospitals provided by insurance company .
- Submit Insurance ID number provided by your Insurance provider to claims department in hospital.
- Submit a copy of policy.
- Check if the pre-authorization form is sent to Insurance company/TPA by hospital’s claim department.
- Provide other details as per Insurance companies queries for verification and approval.
- In case hospitals ask for claim number, you may call on toll-free number for which you should know your(Policy number, name of person admitted, nature of illness).
- The claim number will be informed to you and insurance claim department of the hospital and further process will be carried out by the hospital professionals in claim department.
In cases like Tonsillitis surgery,appendix removal, Ear surgery or any other planned treatment which can be done after getting approved by insurer/TPA.
- In cases like Tonsillitis surgery,appendix removal, Ear surgery or any other planned treatment which can be done after getting approved by insurer/TPA.
- A copy of policy and ID card in the hospital’s claims department.
- Check if the pre-authorization form and other documents are sent to Insurance company/TPA by hospital’s claim department.
- In few cases reimburse is denied due to terms and condition that fall under claims policy.
There may be some hospitals that may not have the cashless facility. In such cases the Insured/claimant has to make a reimbursement claim. The following procedure is to be followed
- Notify to your Insurance provider.
- Correctly fill the claims form and attach it with original test reports and bills which be submitted to Insurance company.
- Collect all original reports and bills, like( ECG,X-RAY,Blood test reports,MRI,CT scan etc.).
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