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Network Hospitals Explained
May 12, 2011

Your Guide to Network Hospitals

What are network Hospitals?

The hospitals which have a tie up with your insurer would come under the category of network hospitals. The network hospital provides cashless health insurance benefits to you on approval by your insurer. The insured, i.e. you, while getting admitted can quote your policy number or provide the card which has been issued by the health insurer to the hospital administration. The hospital will seek approval for treatment on your behalf. If approved, the payments will be settled by your insurer, subject to the cover taken by you.

What are non-network hospitals?

The hospitals which do not have a tie-up with any insurer are called non-network hospitals. If you seek treatment in any of the non-network hospitals, you will have to settle the bills yourself. However the hospitalization expenses will be reimbursed after you submit the claim forms along with the other documents to your insurer. On authentication, the expenses will be reimbursed to you, after deducting some amount as a deductible.

Why prefer network hospitals over non-network hospitals?

If you get admitted to a non-network hospital you will need to settle the hospital bills yourself and then submit the hospitalization documents along with the claim form for reimbursement of the same. Insurer would require the following documents for processing of your insurance claim.
  • A photocopy of your previous policy details prior to taking your Health policy (if applicable).
  • A photocopy of your present policy document.
  • First Prescription from the Doctor.
  • The Claim Form duly signed by the claimant or family member.
  • The Hospital Discharge Card
  • The Hospital Bill giving detailed break up of all expense heads mentioned in the bill.
  • The Money Receipt duly signed with a Revenue Stamp.
  • All Original Laboratory & Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.(Please note that you do not have to enclose the films or plates, a printed report for each investigation is sufficient)
  • If you have purchased medicines in cash and if this has not been reflected in the hospital bill, you need to enclose a prescription from the doctor and the supporting medicine bill from the Chemist.
  • If you have paid cash for Diagnostic or Radiology tests and it has not been reflected in the hospital bill, you need to enclose a prescription from the doctor advising the tests, the actual test reports and the bill from the diagnostic centre for the tests.
  • In case of a Cataract Operation, you might have to enclose the IOL Stickers
This whole procedure can be tiring and frustrating. Also, you will have to be ready with the cash that will be required for the treatment. The out-of-pocket expenses might be huge, which can increase the stress in an already tense situation. Whereas, in case of network hospitals, you will not be required to directly pay for the medical expenses as long as the original bills and evidence of treatment in respect of the same shall be left with the Network Hospital. Therefore it is better to go for network hospitals. All you need to do is select the state and name of the city (as shown in the picture above) to search for a network hospital near you. You can also search for a particular type and grade of the network hospital, as per your requirement. Health insurance has become a necessity in today's world and the facilities offered at the network hospitals add to your convenience in the crucial time of a medical emergency. Insure yourself and your family with our varied health insurance plans to avail the benefits of network hospitals. *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.
Non-Network Hospitals:
The hospitals which have no agreement with the insurer or TPA are called non-network hospitals. If the insured seeks treatment in any of the non-network hospitals, the bills have to be settled by the insured himself. However the hospitalization expenses can be reimbursed by submitting claim forms along with other documents to the insurer or TPA. On authentication, the expenses are reimbursed to the insured.

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