How Cashless facility of health insurance works?

Cashless facility in health insurance is a facility where the insured person can get medical treatment at an empanelled hospital without having to pay any cash upfront. Instead, the hospital directly bills the insurance company for the medical expenses incurred.

Here's an example of how cashless facility in health insurance works:

  1. The insured person falls sick or requires medical treatment and goes to an empanelled hospital.

  2. The insured person presents their health insurance card and provides the necessary details to the hospital.

  3. The hospital verifies the details of the insured person and checks if the treatment required is covered under the insured person's health insurance policy.

  4. If the treatment is covered, the hospital provides the necessary medical treatment to the insured person.

  5. The hospital then sends the bills for the medical treatment to the insurance company for payment.

  6. The insurance company verifies the bills and settles the payment with the hospital directly.

  7. The insured person does not have to pay any cash upfront for the medical treatment received.

In this way, cashless facility in health insurance offers a convenient and hassle-free payment experience for the insured person, as they do not have to worry about paying cash upfront for medical treatment. Additionally, the insurance company has better control over medical expenses and can negotiate rates with empanelled hospitals, which can help reduce costs and improve their profitability.