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All about Network Hospitals


All about Network HospitalsWhat are network Hospitals?

The hospitals which have a tie up with your insurer would come under the category of network hospital. The network hospital provides cashless facilities to the insured on approval by the insurer. The insured while getting admitted can quote his policy number or provide issued card by the health insurer to the hospital administration. The hospital will seek approval for treatment on your behalf. If approved, the payments will be settled by insurer subject to the cover taken by the insured.

What are non-network hospitals?

The hospitals which have no tie-up with the insurer are called non-network hospitals. If the insured seeks treatment in any of the non-network hospitals, the bills have to be settled by the insured himself.  However the hospitalization expenses are reimbursed by submitting claim forms along with other documents to the insurer. On authentication, the expenses are reimbursed to the insured after deducting some amount as a deductible.

Why prefer network hospitals over non-network hospitals?
If you are admitted to a non-network hospital you need to settle the hospital bills yourself and then submit the hospitalization documents along with the claim form for reimbursement of hospitalization expenses.
Insurer would require the following documents for processing of your claim.

  • A photocopy of your previous policy details prior to taking your Health policy (if applicable).
  • A photocopy of your present policy document.
  • First Prescription from the Doctor.
  • The Claim Form duly signed by the claimant or family member.
  • The Hospital Discharge Card
  • The Hospital Bill giving detailed break up of all expense heads mentioned in the bill.
  • The Money Receipt duly signed with a Revenue Stamp.
  • All Original Laboratory & Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.(Please note that you do not have to enclose the films or plates, a printed report for each investigation is sufficient)
  • If you have purchased medicines in cash and if this has not been reflected in the hospital bill, you need to enclose a prescription from the doctor and the supporting medicine bill from the Chemist.
  • If you have paid cash for Diagnostic or Radiology tests and it has not been reflected in the hospital bill, you need to enclose a prescription from the doctor advising the tests, the actual test reports and the bill from the diagnostic centre for the tests.
  • In case of a Cataract Operation, you might have to enclose the IOL Stickers

This whole procedure can be tiring and frustrating. Along with the above procedure, there is a deductible applicable in case of non-network hospitals

In case of network hospitals, the insurer negotiates the treatment cost with the hospital and tries to get you the least possible rate and the best possible service.   Also, you will not be required to directly pay for the medical expenses at the Network Hospital as long as the original bills and evidence of treatment in respect of the same shall be left with the Network Hospital. Also, there is no deductible in this case.

There fore it is better to go for network hospitals

To see a list of all the Bajaj Allianz network hospitals in your city, please follow this link:
https://apps.bajajallianz.com/gmlocator/hospitals.php

Non-Network Hospitals:


The hospitals which have no agreement with the insurer or TPA are called non-network hospitals. If the insured seeks treatment in any of the non-network hospitals, the bills have to be settled by the insured himself. However the hospitalization expenses can be reimbursed by submitting claim forms along with other documents to the insurer or TPA. On authentication, the expenses are reimbursed to the insured.

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Published on:12 May, 2011

By: | Tags: , , , | Comments: 139

Comments

139 thoughts on “All about Network Hospitals

  1. DR. TAIYAB KHAN

    Dear Sir,
    With great pleasure, I would like to introduce to you “Sania Hospital” is a 100 bedded multi-specialty medical Center established in 1992 at 249,N.E.B. Subhash Nagar, Alwar in the State of Rajasthan. Sania hospital located in the center of N.E.B and Nearest of Railway Station, 60 ft Road & Delhi Highways.
    We are desirous of having our esteemed organization on your panel and are therefore submitting a synopsis of our hospital with all it facilities.

    The aim of the organization is to create an infrastructure of quality health care services at the district level of Alwar; The Sania Hospital is to provide quality and compassionate care for at affordable cost. We are already panel – Alankit Healthcare Services, TTK Health Care Services, Star Health Care Services, Good Health Plan Pvt., Health India TPA Pvt. Ltd, Apollo DKV Health Insurance Co. Ltd, E-Meditek Solutions Ltd, Cholamandalam General Insurance Co & United Health Care Pvt. Ltd.

    Please find enclosed herewith the following desired information for your kind perusal.

    Thanks and regards

    Sania hospital

    0144-2373369

    Reply

  2. hemant shukla

    what is the limit of amount for intracular lens cataract operation and which hospital provides cash less in vadodara, gujarat..

    Reply

  3. Ashok Kumar Patnaik

    maharajah’s Institute of Medical Sciences is a medical college with 575 beded hospital. we are providing services for your customers but we have no tie up with you so we are interested to tie up with you to provide your costomers cashless services.Kindly send MOU for this.
    Thank You

    Ashok Kumar Patnaik,
    Marketing MNanager
    Mob. No-098851*****

    Reply

  4. Sheshagiri

    Hi, can you please provide network hospitals / where Bajaj Allianze travel insurance is recognised and take out patient as insured in USA. I live in Chicago -Vernon Hills area.

    Thanks

    Reply

    • CFU

      Dear Rajiv,

      Please provide us the updated contact details so that we can arrange the call back from our sales department.

      Thanks and Regards,
      Help and Support Team

  5. Samrat Bhate

    In need the hospital network / list of hospital covered under bajaj life & general insurance policies.Can you pls do the needful.

    Reply

    • CFU

      Dear Samrat,

      Thanks for writing to us.

      We will send you a link for the same on your email id.

      Thanks and Regards,
      Help and Support Team

  6. Dr.M.PRAVEEN KUMAR REDDY

    Can you please send the details of the NET WORKING DEPARTMENT,AS I WANT TO GET MY HOSPITAL EMPANELED WITH YOUR FIRM

    Reply

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