Network & non-network hospitals: How do they affect your claim?

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A medical emergency can come knocking at your door anytime. It is always wise to be prepared for such times through both preventive health care and the shield of insurance. With insurance you can be financially prepared to get the right treatment at the right time without any compromise. A health insurance plan keeps your mind at peace since you have a shield for your savings that would otherwise get wiped out given the rising prices of health care. 

Among the many benefits that health insurance has to offer, one that stands out is the cashless treatment benefit. This facility is made available through the network hospitals that the insurer has. Essentially network hospitals are those with whom the insurer has a tie-up to offer their policy holders the facility of cashless treatment. With the cashless treatment benefit, you don’t have to bear the medical expenses from your pocket and can still avail the right treatment. 

In this article we will help you understand the difference between a network and non-network hospital. We will also explain how it affects your insurance claim settlement. 

What are network hospitals?

Network hospitals are those with which your insurance company has collaborated. These hospitals are on the list of your insurer. Every health insurer has a tie-up with different hospitals, clinics, and care centres. 

So, when you get admitted to any network hospital, you can avail cashless treatment facilities, according to your policy’s terms and conditions. 

What are non-network hospitals?

Unlike a network hospital, non-network hospitals have no collaboration with any insurance company. Hence, you cannot avail cashless payment benefit at such hospitals. If admitted to a non-network hospital, you will have to bear the healthcare treatment expenses and get it reimbursed later.

How do network & non-network hospitals affect your insurance claim?

At a network hospital you can raise a cashless claim and you don’t need to worry about paying the treatment costs. In case of a planned medical procedure, approval must be taken from the insurance company, after which the cost of your treatment will be covered under your insurance plan. 

When it comes to emergency treatments, the hospital reports the same to the insurance company, which then pays for your treatment. 

At a non-network hospital, a reimbursement claim is required to be filed for any treatment you avail. The claim that is to be settled depends on the medical bills you provide as evidence to the insurer. All this takes a little longer to process a reimbursement claim since the verification of medical bills is an important step for the insurance company. 

We hope you now have a clear understanding of how it works and what is the difference between network and non-network hospitals. You can explore a host of health insurance plans on the Bajaj Finserv App and also check the network hospitals near you on the plans.

Anywhere, Anytime insurance with the Bajaj Finserv App!

The Bajaj Finserv App is a high-utility app that takes care of all your financial needs including insurance. On the app, you can explore health insurance plans from our trusted partners. Here you can view product features, compare prices, and purchase a plan that is best suited to your needs. All this in a matter of minutes on our 100% digital platform and from the comfort of your home. It truly is becoming the new way to buy insurance.

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