Term of the week: Cashless mediclaim

Cashless mediclaim services offer an insured person the benefit of availing oneself of medical treatment at the network hospitals of the insurer without having to pay for it. Hospital bills (up to the sum insured) are directly settled by the insurance company.

In case of planned hospitalisation, such as cataract or knee-replacement surgery, you can start the process in advance. Once you finalise the hospital, you have to go to the hospital and collect the ‘pre-authorisation’ form from the insurance desk. While part 1 of the form needs to be filled by you, part 2 — on the procedure details and its cost — has to be filled by the doctor. The form is then sent to the insurer/TPA (third-party administrator). If approved, an authorisation letter indicating the amount sanctioned for the procedure is sent to the hospital.

If it is, however, an emergency hospitalisation, make sure you inform the insurer/TPA within 24 hours of hospitalisation. If the treatment has to start immediately, you may have to pay an initial deposit, which will be reimbursed later.

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