Health Insurance Guide

Your easy guide to avail Cashless hospitalization

Do all Health Insurance Policies offer cashless hospitalization facility?

Today, most Health Insurance policies do offer cashless hospitalization facility and route your policy through a Third party Administrator (TPA). However you should be familiar with the terms- Network Hospital and Non-network Hospital.

Network Hospitals are those hospitals that your TPA has an agreement with. In case of hospitalization, if you get admitted to a Network Hospital you will be eligible for cashless hospitalization, subject to the other terms and conditions mentioned in your policy being fulfilled. In case you are admitted to a Non-network Hospital, you will have to settle the bills directly to the hospital and then seek re-imbursement through your TPA.

Does cashless hospitalization mean I can just walk into a hospital and get admitted for treatment free of cost?

First, you need to be clear that there is no free treatment. It is just that, in the case of a cashless hospitalization, the insurance company will bear the cost of treatment either fully or partially on your behalf.

Cashless hospitalization is a facility provided by most health insurance policies and enables an insured customer to obtain admission and undergo the required treatment without a direct payment. The assigned TPA will mediate between the healthcare service provider (hospital) and the insurance company and settle the bills on behalf of the insured customer.

However it is important to understand the role of a hospital in cashless hospitalization. The hospital is only a facilitator and has no authority to approve or disapprove any request for cashless hospitalization. Certain protocols lay down by the Insurance Regulatory and Development Authority (IRDA) with respect to cashless hospitalization will need to be adhered to strictly.

Who are the TPAs with whom K.M. Memorial Hospital has a tie-up?

K.M. Memorial Hospital has a tie-up with several TPA’s. (Current list is given below). However this is dynamic and will change from time to time. Kindly contact the Corporate Help Desk for an updated list

Who are the Corporate with whom K.M. Memorial Hospital has a tie-up?

OUR CORPORATE COORDENATOR IS MR. JAYANT MUKHERJEE:
CONTACT NUMBER 09955118235