A cashless health insurance policy settles your claim directly with the hospital, so that you don’t have
to pay the bills from your pocket at the time of discharge. But this is a layered process and can take
some time. Yet, insurers boast of quick claims approval time. Both statements can be true. Read on to
know how.

For a cashless settlement in health insurance, the process of making a claim starts with getting pre-
authorization from the insurer. This is merely an acknowledgment by the insurer that the claim is
payable. It doesn’t give any guarantee that your claim will be cleared.

Read More: [url]List Of Documents Required[/url]=https://claimtherapist.com/blog/27

You and the treating doctor need to fill the pre-authorization form. You need to fill in the personal and
insurance policy details. Then the form is sent to your doctor for filling in details of the ailment and
treatment. The form is then sent to the billing department to give an estimate and then it is sent to the
insurer, with the necessary documents.

The insurer reviews these documents to pre-authorize the claim. And this is where the insurers boast
of a quick turnaround time.

Read More: [url]Claiming Health Insurance?[/url]=https://claimtherapist.com/blog/25

But keep in mind that the insurer may still ask for additional documents at this point itself, by typically
putting in a query. This query must be replied to in order to approve the claim, and that could take
time.

Pre-authorization approvals usually mean that an initial amount has been sanctioned by the insurer
along with admitting to paying the claim subject to the final bill from the hospital.
So it’s at the time of discharge that the insurer actually pays. Non-payables will have to be paid by
you.

In some cases, hospitals may demand a security deposit—especially in cases of unplanned events
where admission cannot wait for pre-authorization from insurers.

Pre-authorization has now comparatively become a quick process, but claim filing and settlement at
the time of discharge can still be (and is) a lengthy process.

For instance, in order to process the claim, an insurer will need the discharge summary that is
provided by the hospital, which itself can be a long process.

Once the discharge summary and hospital bills are sent to the insurer, it will investigate and scrutinise
the bills before settling them. And this may take time because the final claim undergoes several levels
of scrutiny.

For you, this means a longer waiting time before you can finally leave the hospital.
It’s important to know that when an insurer promises quick approval of claims, it may not mean that
you will also be able to walk out of the hospital with all your bills paid by the insurer in no time. It
simply means a quick turnaround on whether the insurer has agreed to accept the claim and not
process the claim.

The final claim is still subject to adjudication by the insurer.
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Also Read: [url]All About Non-Medical Expenses[/url]=https://claimtherapist.com/blog/26