Insurance companies for the benefit of policy holders have introduces cashless mediclaim. Insurance companies have appointed TPA’s (Third Party Administrators).
Insurance companies have designated hospitals on their list, which they give to their policy holders and it is compulsory for the policy holder to take treatment from these designated hospitals only.
The policyholder is given a photo identity card, in which the TPA’s name is mentioned.
In cashless treatment, the patient who is admitted right from admission to discharge all his expense are taken care of by the hospital. It is the hospital’s responsibility to give all details of patient admission / discharge. To the TPA before treatment starts. The TPA will study the details and give authorization letter between twenty four to forty eight hours.
After receiving of Authorization letter from TPA all expenses right from the admission till discharge are borne by the hospital, and then claim the said amount from TPA by producing necessary documents.
Thus, cashless mediclaim policyholders enjoy following advantages.
In case of emergencies/accident, all medical expenses are taken care of and the policy holder does not have to take out a single rupee so the policy holder doesn’t have to worry about the expenses. Earlier the patient had to spend on the treatment and then claim the said amount from the company.
Points to be noted
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For availing cashless facility, higher premium has to be paid by policyholder.
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Policyholder who registers under cashless will be given a photo identity card.
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Cashless facility is given to those policy holders who get admitted only.
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The policyholder can claim all expenses on treatment, one month before admission & two month after discharge. Of course, to claim the said amount from the insurance company, policy holder has to submit necessary papers, bills, etc., to insurance company.