Is The Health Insurance Claims Process Easy?

Health Insurance Claims Process: Making a health insurance claim has become easier over time. Find out how to make a claim the easy way. Read now!

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Medical emergencies can cost a lot of money. Fortunately, with a good health insurance policy, you have a safety net to fall back on — it will cushion the impact of healthcare expenses and ensure you get back to good health without worrying about the costs. All you have to do is submit a claim and your insurance provider will swoop in and bear the financial burden for you. What’s more is that, filing a health insurance claim has also gotten easier over the years.

Today, you could go completely cashless

Every health insurance provider will have a list of network hospitals. If you undergo treatment at one of these hospitals, you can opt for a cashless claim. To do this, simply provide your insurance details at the hospital third party administrator (TPA) desk at the time of admission. After this, your insurance provider will directly settle the bills with the hospital as per policy terms and conditions and you can focus on getting well again — easy, isn’t it?

Of course, getting a cashless claim depends on two basic factors. First, the hospital should have a tie-up with your insurance provider. Second, the conditions for which you receive treatment should be covered by your health insurance policy. It is best you confirm both these details before or upon your admission.

You could also get your expenses reimbursed

It is not compulsory to get treatment at a network hospital; you can visit any other hospital as well. However, in this case you will not be able to avail yourself of cashless claims. You will pay the bill from your pocket following which you will make a reimbursement claim with your health insurance provider. In this case, you will have to follow these simple steps.

  1. Inform the insurance company: The first thing you need to do is intimate your insurance provider. Let them know that you’ve been admitted to a hospital, and that you are undergoing treatment.
  2. Fill the claim form: After being discharged, you need to fill the claim form and get it signed from your consulting doctor. You will have to attach original copies of your hospital bills, medicine bills, medical reports, and discharge card. The duly filled claim form along with the aforementioned documents needs to be submitted within the stipulated time period.
  3. Get reimbursement: The insurance company will evaluate your claim, and if all the necessary documents are in place, all your covered medical expenses will be reimbursed as per policy terms and conditions.

The health claims process has become easier over the years. The health claim payment which took weeks previously, now takes a few days at the most. More and more insurance companies are integrating technology into their plans to make things — especially the claims process — seamless and easy for policyholders.


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