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Wednesday, 18 April 2018

What are network and non-network hospitals? How does it affect your health insurance claim?


Health is wealth, there is no doubt in this statement. We all know that a good health is much more important than holding lots of wealth. A person with a good health will be able to earn huge wealth that can provide a quality life. Whereas, if we talk about a person who does not have good health, he will spend all of his savings and wealth in getting the right treatment for it. It is true that good health can never be compromised.

So, are you taking the essential steps to secure it? Regardless of all precautions, we still fall sick, meet accidents and they are out of control. You can't control it, but you can prepare yourself to fight against it. Most of the time we fall prey just because of the economic crisis. In several cases, we have to stop working just because of poor health. Sometimes we were unable to bear the burden of heavy healthcare expenses, in such cases, we have to spend all of our hard-earned money to get proper treatment.

In most cases, people borrow money from friends and relatives to get the required treatment. But with the help of an effective health insurance plan, you can completely focus on treatment rather than the cost involved in it. If you are not fine with the reimbursement concept of health insurance then it is advisable for you to have a look at the cashless benefits. Cashless hospitalization refers to the concept where the insurer will pay directly to the hospital for your treatment and you will be able to have quality treatment without paying a single penny from your pocket. But to avail cashless benefits you have to get the treatment in a network hospital otherwise you will not be liable for the treatment.

What are Network Hospitals?
There is no doubt in saying that health insurance companies know the fact that the hospital will charge more from a patient with a cover as compared to those who may not have a cover. It can be a huge loss for insurance companies. For turning the same into profitability and reducing the level of losses, they tie up with a hospitals and make them a part of network hospitals. Thinking about the convenience that they offer, many policyholders prefers to visit in-network hospitals for various treatments. Network hospitals gradually become the part of the broad hospital network with whom some insurance companies are associated.

It is advisable for those who are purchasing a medical insurance policy that pay attention to its features and the list of network hospitals. It will help you in saving a lot of money and the insurer will have no issue at the time of claim settlement. Under the process of a network hospital claim settlement, the insurer will check all the relevant documents of patients and his/her policy and give a final approval of the claim settlement after checking the policy terms and conditions and hospital bills.

Who wins?
A person who takes the advantage of treatment in a network hospital surely gets more benefits compared to non-network ones. The reason behind the same is that in a network hospital he/she will be able to get the quality treatment without paying a single penny from his/her own pocket. In such situation insurer will take care of all the expenses. It is always a wise decision to go for a treatment in a network hospital.

Mostly all insurance companies provide a list of network hospital to the consumer along with the policy documents at the time of purchase. It is usually a good idea to have a handy list of all network hospitals that can provide quick help in the case of any emergency. This list and its related coverage acts like a savior in case when you need it the most. Through it, an insured can easily approach a network hospital and can take benefits of insurance policy. He/she will get medical treatment at an affordable cost and can avail the cashless benefits as well. In the case of pre-planned hospitalization, the insured must inform the TPA beforehand and take all the necessary approvals. You must rely on non-network hospital only in case of unavoidable emergencies.

It is thus important that the insured pays all the premium on time in order to get better coverage in case of need. They can expect to be taken care of during hospitalization without worrying about burdening their pocket with extra expenses. Thus, having treatment in network hospital is much better than having it in a non- network hospital for the benefits they offer to the insured.

Having a cashless treatment is always a wise option. With the same, a person and his/her family would be able to take proper care of the patient rather than arranging funds for the treatment. The insurance company will be there to clear all the bills on time on behalf of the insured.