No One Likes going to hospital, But at Least It Should Be Smooth & Cashless | Edelweiss Insurance

31st January 2022 8min read 345 views

Hospital admission can be a stressful experience. Here are some steps to avail your cashless service smoothly.


Step 1: Download your policy copy from the insurance company website. Then download your Health ID Card from the insurance company website or from the Third Party Administrator (TPA) website that your insurance company has partnered with. If you are not sure, simply call the customer service number of the insurance company and ask them for your Health ID Card. This is the most important document you need to avail cashless hospitalisation service.


Step 2: Keep the digital copies of your Driving Licence, Aadhar or Passport ready for identity proof.


Step 3: Additionally, keep the digital copy of your Pan Card ready, as some hospitals do ask for it for larger cashless claims.


Step 4: Your hospitalisation may be planned or unplanned, and your actions should depend on this. For planned admissions, call the selected hospital and check if they are part of the cashless network of your insurance company. Alternatively, you can look up the insurance company website to check if the hospital is in-network and offers cashless health insurance.


Assuming that the hospital is part of the network, you need to then ask for the TPA desk of the hospital. The best thing to do is to visit the TPA desk a day in advance and share all the digital copies via email. Please watermark these documents before clicking the pictures, to avoid any identity theft or misuse.


At the TPA desk, fill all the Forms needed for the approval of a cashless claim. Ideally, a Doctor's letter is needed, recommending the need for admission. You may already have it from the doctor, or the TPA desk will arrange for the same. The entire process should take 1-2 hours.


Step 5: Ensure that the TPA desk has submitted the cashless request. Most insurance companies respond within 1 hour to 3 hours with approval, denial, or a request for additional documents. Your hospital TPA desk will coordinate with you for the next steps.


Step 6: Ideally, you should carry a credit card or debit card, as some hospitals insist on a deposit amount even if the cashless facility is available. They will let you know this amount as part of their financial counselling.


Following these steps will help you complete your cashless hospitalisation process smoothly. Here are the best practices -

- In case of a planned admission, start the process a day or two in advance

- Take the phone number of the person at the TPA desk 

- Be courteous and respectful at the TPA desk 

- For easy sharing, carry digital copies of all documents mentioned above in your image gallery, WhatsApp, Google Drive or digi locker

- Carry some cash or a debit/credit card, and maintain some balance in your bank account

- Having the customer service number of your health insurance company or TPA will always be handy

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