List of Health Insurance Network Hospitals in India
Girish Kumar, a 45 years old man had purchased a health insurance policy for a coverage value of Rs.5 lakh. He was recently diagnosed with a kidney stone issue and was advised surgery on an immediate basis. Due to the emergency nature of his medical condition, he got hospitalized in a nearby hospital as he did not have time to check for the preferred one under the hospital name list. The surgery was successful and within the next few days, he was also discharged but he had to pay nearly 4 lakhs from his pocket towards all the medical costs. If he had the time to choose a cashless hospital from the health insurance network hospital list, he could have made use of his health insurance coverage, without having to spend for the treatment on his own.
Imagine a scenario where your health insurance company rejects your health insurance claim since you were admitted to the hospital with an emergency medical issue in a hospital that is not part of their network hospital list. This could be a terrible situation for you and your family. A health insurance policy helps you cover medical expenses, which is very much required during the current times when costs of medical treatments are increasing.
There are high chances of rejection of your medical insurance claim if you don’t have a thorough understanding of the claims process or about the health insurance hospital list. Hence, we have listed the direct links of health insurance companies where you can find the list of network hospitals.
List of Health Insurance Network Hospitals in India
Types of Hospitalization
A policyholder can file a claim for reimbursement of medical expenses after getting hospitalized for medical treatment. But the type of claim varies with whether the hospitalization happens in a network hospital or a non-network hospital.
The insurance providers choose their preferred network of hospitals based upon various background checks, efficiency, expertise, and availability of medical services. If the network hospital doesn’t offer quality care, the tie-ups won’t be renewed.
- Network hospitals chosen by health insurance companies offer cashless hospitalization to policyholders. Cashless treatment network medical hospitals are available up to the policy’s maximum sum insured and according to the terms and conditions.
- Non-network hospitals will require you to pay the full amount and after discharge, one can request reimbursement from the insurer or TPA. If the insurance company considers it reasonable, your request will be approved, or else it could partially have settled or fully rejected.
It is the reason why when purchasing an insurance policy, it is always necessary to ensure that you select a policy that covers a large number of hospitals in your area.
Types Of Health Insurance Claims
Knowing the process of an insurance claim is essential if you have a health policy. There are two types of claim settlements in healthcare claims processing, including, Cashless Claims and Reimbursement Claims.
1. Cashless Claims: As the name implies, there is no need for you to pay for your medical treatment at the time of hospitalization to a network hospital recognized by the insurer or TPA. By presenting the cashless card issued by the insurer at the insurance desk of the hospital, a policyholder can get treatment at any network hospital of the health insurance provider. Insurers will pay all hospitalization and treatment costs directly.
Cashless Claim Procedure: Once you’ve decided to go to the hospital for treatment, follow these steps to access the cashless facility.
- Choose a hospital within the network of hospitals offered by your insurance company. For faster claims approvals and fewer headaches, you can choose to filter them according to the Claim Settlement Ratio.
- Notify the TPA of your intention to be admitted at least 3 days before, by quoting your hospital name and membership number.
- Submit the cashless claim form to the hospital with all the relevant medical records and within a few hours, approval will be granted after inspection of all details.
Once the approval has been granted, the hospital bills will be paid directly by the insurer, since the hospital features in the list of preferred hospitals of the insurer.
2. Reimbursement Claims: The reimbursement claims process works in a similar way to cashless claims but the only difference is the time it takes to get your claims. A reimbursement claim is when the insurer reimburses you for all the medical expenses after you have been treated at any non-network hospital.
The policyholder must pay the hospital for treatment, and then file for a reimbursement claim to the TPA/insurer with all medical records and bills. Once the verification of all the submitted documents is completed, the reimbursement claim shall be processed.
The Conclusion
As a policyholder, you should always choose a health insurer or TPA that offers a wide range of hospitals for your treatment under its network. This will help you narrow down your choice of insurer. It is not a good idea to base your decision solely on the premium rates and plans but also equal importance should be given to the health insurance TPA hospital list or the cashless hospital list affiliated by the insurer.
