A Hospital which is not included in the Network Hospital list can still be approached by the patient and later on claim for Health insurance claim reimbursement.
All Insurance companies appoint a TPA (Third party administrator) to deal with the hospitals for processing Health insurance related matters. The chain of hospitals that are linked with TPA where we can claim our health insurance is called the Network hospital to the TPA. Generally various TPA’s have a tie up with many leading hospitals, for the easy and faster claim of health insurance. The reimbursement payment or cashless facility that we receive from the insurance company will have to be based on the ailment report and the cost incurred to the hospital for providing treatment to us.
An insurance claim cannot be done in a hospital not listed under the network of the TPA. So while choosing a health insurance it is equally important to look into the network of hospitals that are linked to the TPA appointed by the insurance company.
SPECIALIZED HOSPITAL NETWORK
Also, our health insurance can be claimed for specialized treatments for heart, kidney, etc. Each plan is different. There are also plans that offer preventive covers like hospital visits, claim over a test that is taken at the hospital or even for our prescribed drugs. But each one of these plans will be available only in the hospital that comes under the network of our insurance company.
Recommended Read :
- How to Get Health Insurance for The Aged?
- How to Select a Health Insurance Plan?
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- Selecting Your Health Insurance Provider
- What Exactly is Lifetime Renewal of Health Insurance?
- Cashless Hospitalisation – Not Always Cashless
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- Role of TPA in Health Insurance
- Pre and Post Hospitalization Health Insurance
- Possible Reasons for Health Insurance Claim Rejection
- Quick Health Insurance Policy – Beware
- What is Network Hospital for Health Insurance?
- What is Planned Hospitalisation?
- Emergency Hospitalisation
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- Preventive Health Care Plan
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- What is An OPD Cover Health Insurance?
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