This provides them a sense of security to get their treatment
done in any network hospital during tough time when their child is not present with them.
Under the process, if the policyholder gets
admitted in a network hospital referred technically as the Preferred Provider Network (PPN), all expenses are directly settled by the insurance company through Third - Party Administrators (TPAs) who act as an intermediary between the hospital and the insurance company.
The policyholders of Apollo Munich can get themselves treated
in network hospitals of the city and enjoy cashless hospitalization.
Cashless is a mechanism wherein a patient is
treated in a network hospital, then insurer settles either the part of the claim or the entire claim with the hospital.
Daily Cash for Choosing Shared Accommodation - A lump sum amount is paid if the insured chooses a shared
room in a network hospital.
If your treatment
undergoes in a network hospital, you don't need to shell out money from your pocket because Apollo Munich Health insurance will settle your claims directly with the hospital.
In such cases the TPA would not be able to help you and you would have to go through the usual claim process
eben in a network hospital.
There are health plans in the market that cover both hospitalization and OPD treatment costs on a cashless
basis in network hospitals and clinics.
Presently, when a policyholder gets
admitted in a network hospital that offers cashless claim settlement service, the hospital administrator sends an email to the insurance company about the patient's details and policy id to seek their approval.
The United India Super top up plan covers both cashless facility (if
hospitalized in a network hospital) and reimbursement facility (if treatment done in a non-network hospital).
Health Plans offer a bundle of benefits ranging from offering cashless
hospitalization in the network hospitals, pre and post hospitalization expenses, in - patient hospitalization expenses, day care procedures, tax benefit under section 80D, etc..
Though health insurance policy provides for cashless reimbursement for treatments
undergone in networked hospitals but claims can also be raised for expenses incurred on treatments undergone in other hospitals or treatment centers for conditions covered by the policy.
The cashless hospitalization service of Apollo Munich Health insurance allows you to get medical treatment
in its network hospitals in Mumbai.
Dear Vijayakumar, Claims can be of two types - cash less claim (
in network hospitals) or reimbursement claims (you pay first from your pocket and then claim from your insurance company).
That administrator said emphatically that it was unacceptable for the doctor to charge me out of network rates if he chose to work at
their in network hospital.
Your anesthesiologist may be out of network even at
an in network hospital.
To avail a cashless settlement of your claim, you should be admitted
in a network hospital.
National Insurance Varistha Mediclaim Policy provides cashless facility for treatments in network hospitals
Check out the list of the PPN hospitals and always get admitted
in a network hospital to ensure cashless mediclaim settlement.
Cross-Reference the List of Network Hospitals — For a cashless claim, you need to be admitted
in a network hospital, technically called a Preferred Provider Network.
In such cases, the insured or his family is asked to bear the costs and later get them reimbursed from the insurer despite the insured being admitted in a network hospital
The following examples will offer a better understanding of the major difference between getting admitted
in a network hospital and a non-network hospital, and how it can impact health insurance claims:
Most health insurance plans provide cashless treatments
in networked hospitals.
Cashless processing — In case of treatment
in network hospitals, a TPA helps in cashless processing under a health insurance policy.