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pays for your hospital bills for diagnostics, surgery etc.

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Challenges Faced Under Cashless Health Insurance Claims

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Over the past few years, the popularity of cashless health insurance has shot up several notches and for quite the reasons most apparent. The major advantage of this Policy is to ease the burden of financial losses that need to be incurred at the time of any unforeseen accident. Holding a cashless Health Insurance means that the Hospitalization and other charges are taken care by the service provider. Cashless service calls for a hassle-free process in which you do not have to bother about the cash in case of any emergency. However, there are a few challenges that people have to face while dealing with cashless health insurance claims

Some of the major reasons behind challenges faced during the utilization of cashless health insurance are: lack of sufficient knowledge, the companies not disclosing the facts properly, difference in Proposal forms, and excessive expenditure. Normally, the customers are not completely aware of the Exclusions of their cashless health insurance. This happens when they do not go through the terms and conditions while buying the insurance. The easiest way to avoid this is going through the terms and conditions provided by the insurance company. Most of the companies provide a free-look period of about 15 days in which you can either continue or cancel the contract if you feel it does not serve your purpose adequately.

Another challenge that customers have to face while claiming for cashless insurance is unavailability of hospitals in the insurer’s chain. Quite a few times, the customers are not provided with a list of the hospitals in which services are available, which makes the matters worse, during emergency cases as one would find it difficult to get to the listed hospital. Even if you managed to get everything right, the turnaround time for the insurance Claim can be a real pain in the back. There is usually a long and painful process in which the customers are left running between the hospital and insurance office. At times, simple things such as sending a mail or fax takes up two hours.

In case of planned admits, the process is somewhat simplified as the customers have the upper hand as far as time factor is concerned. Another issue that quite a few customers face during the claim of cashless insurance is a rejection of their cases in the lack of adequate information. Though the services differ from TPA to TPA, but customers are generally at the receiving end. If a few steps are followed the hassles can be avoided to a great extent. So, it is better for you to get the list of the hospitals under cashless service, read the terms and conditions properly, inform the TPA as soon as possible and always be ready with documentations.