Your Easy Guide to Cashless Hospitalisation
K.M. Memorial Hospital is a network hospital with 30+ insurance TPAs and major corporates. Understand your rights and how cashless treatment works.
Does my Insurance offer Cashless Hospitalisation?
Today, most Health Insurance policies offer cashless hospitalisation facility and route your policy through a Third Party Administrator (TPA). It is important to be familiar with two key terms: Network Hospital and Non-Network Hospital.
Network Hospitals are those hospitals that your TPA has an agreement with. If admitted to a Network Hospital, you are eligible for cashless hospitalisation, subject to the terms and conditions of your policy. If admitted to a Non-network Hospital, you must settle bills directly and seek reimbursement through your TPA.
What does "Cashless" actually mean?
There is no free treatment. In a cashless hospitalisation, the insurance company bears the cost of treatment either fully or partially on your behalf. The assigned TPA mediates between the hospital and the insurance company and settles bills on behalf of the insured customer.
It is important to understand that the hospital is only a facilitator and has no authority to approve or disapprove any request for cashless hospitalisation. Protocols laid down by the Insurance Regulatory and Development Authority (IRDA) must be adhered to strictly.
