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Insurance Article

5 Things You Need to Know About Cashless vs Reimbursement Policy Now!

August 10 2018

Here we tell you all there is to know about policies with cashless claims and reimbursement claims process

For those of you having a health insurance policy or mediclaim insurance, you must be well aware of the claim settlement process. After the insured has been hospitalized and is about to be discharged, the bill needs to be settled by the insurance company. This can be done in two ways: through a reimbursement claim or the cashless route. Most insurers today prefer the cashless route due to it being convenient and faster.

Here we will tell you what these claim procedures are all about. Read on to find out.

What is Cashless Claims?

An insurer has a network of hospitals that the insured can be hospitalized in, for both, emergency and planned hospitalization. If the insured is admitted to one of these networked hospitals and just shows his health insurance card, then the claim will automatically become cashless. Which means that the insurance company will directly pay the claim to the hospital on your behalf; you won’t have to pay anything, i.e. cashless medical insurance.

What is a Reimbursement Claim?

Reimbursement claims are the traditional way of settling claims of a medical claim policy. It is also a lot slower and cumbersome way of settling the hospital’s dues as compared to a cashless claim. In this process, the insured will pay for the medical expenses out of his own pocket. The original paid medical bills and the medical reimbursement form will then be given to the insurer, who will reimburse the insured for the expenses incurred.

Advantages and Disadvantages of Reimbursement Claims

Reimbursement claims have their disadvantages as well as advantages. The advantage is that, the insured can get treated at any hospital and does not need to enlist in a networked hospital. The disadvantage here is that the insured will have to bear all the medical expenses initially.

He will also have to support the claim with original medical bills, failure to produce which will result in rejection of claim. Then, there is also the duration: reimbursement claims take time to settle, unlike cashless claims which are done immediately.

Advantages and Disadvantages of Cashless Claims

Cashless claims are slowly becoming the norm in the health insurance industry, but they also have a disadvantage. One major problem is that, to avail the facility, the insured will have to get treated in a networked hospital. If the hospital in not listed as a networked hospital, then cashless claims won’t be possible, instead the insured will have to stake a reimbursement claim.

The advantages of cashless claims are many. The process does not require the insured to save all medical bills for proof later on, as the insurer directly gets in touch with the hospital and settles the claim. Secondly, there is no need for the insured to carry cash or have the required money with them as the settlement is taken care of in a cashless manner.

Mediclaim Insurance for the Rainy Days

Illnesses never seek permission before striking. It’s always a wise to opt for mediclaim insurance. Mediclaim policy for family and individuals that offers both cashless health insurance, and an easy reimbursement policy, in case if you haven’t opted for a cashless one.

Related Article:

Uninsured and Underinsured: An Issue That Needs Addressing
Late in Filing Insurance Claim? Can it be denied?

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