Everything About Cashless Everywhere
Introduction
In a significant leap forward for the Indian insurance industry, the ‘Cashless Everywhere’ initiative has been introduced by the General Insurance Council (GIC) in collaboration with health and general insurance companies. This groundbreaking system aims to revolutionize the way policyholders access medical treatment, making it more convenient, transparent, and hassle-free.
What Is ‘Cashless Everywhere’?
Under the ‘Cashless Everywhere’ system, health insurance policyholders now have the freedom to seek cashless treatment in any hospital, regardless of whether it is part of the insurer’s network. Here’s how it works:
- Hospital Freedom: Policyholders can choose any hospital for treatment, even if it is not in the network of the insurance company. This flexibility eliminates the previous constraint that limited cashless services to network hospitals only.
- Simplified Claims: The initiative aims to simplify claims processing. Previously, policyholders had to opt for reimbursement when dealing with non-network hospitals. Now, they can enjoy a seamless cashless experience, reducing the stress of upfront payments.
- Boosting Trust: By expanding the cashless facility beyond network hospitals, the system aims to reduce fraud and build greater trust in the insurance industry.
Benefits to Hospitals
- Increased Footfall: By participating in the ‘Cashless Everywhere’ system, hospitals open their doors to a wider patient base. Policyholders can choose any hospital, leading to increased footfall and potential revenue.
- Streamlined Processes: Hospitals no longer need to wait for reimbursement approvals. Cashless transactions ensure prompt payment, reducing administrative burden and improving operational efficiency.
- Enhanced Reputation: Hospitals that offer cashless services gain a competitive edge. Patients appreciate the convenience and trust hospitals that prioritize their well-being.
- Reduced Financial Risk: With direct settlements, hospitals avoid the risk of delayed or rejected reimbursements. This financial stability benefits both hospitals and patients.
Guidelines for Hospitals
- Admissible Claims: Hospitals must ensure that the claim adheres to policy terms and guidelines. Admissible claims are eligible for cashless settlement.
- Timely Communication: Hospitals should promptly inform insurers about planned admissions (at least 24 hours prior) and emergency treatments (within 24 hours of admission).
Cashless Everywhere in Gujarat
How Does It Benefit Policyholders?
- Wider Hospital Choice: With the ‘Cashless Everywhere’ initiative, policyholders can seek treatment in any hospital they choose, irrespective of network affiliations. Hospitals with 15 beds, registered under the Clinical Establishment Act, can now offer cashless hospitalization.
- Massive Ecosystem: An entire ecosystem of up to 40,000 hospitals across India will be available to all insurers. This extensive network ensures that policyholders have access to cashless services wherever they are.
- Admissible Claims: To avail of the cashless facility, policyholders need to follow these guidelines:
- For elective procedures, inform the insurance company at least 24 hours prior to admission.
- For emergency treatment, notify the insurance company within 24 hours of admission.
Industry Leaders Speak
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, and Chairman of the GIC, emphasized the importance of a frictionless claims process. He stated, “We wanted to make the whole journey of claims a frictionless process, which will not just improve the policyholder’s experience but will build greater trust in the system.”
Conclusion
The ‘Cashless Everywhere’ initiative is a game-changer for health insurance in India. It empowers policyholders, streamlines processes, and encourages more people to opt for health coverage. As we move toward a future where healthcare decisions are made without financial barriers, this initiative stands as a beacon of progress.
Remember, whether it’s a planned procedure or an emergency, timely communication with your insurer ensures a smooth cashless experience. So, embrace the freedom, choose your hospital, and let the ‘Cashless Everywhere’ system work for you!
For all your hospital-related needs, OASIS is your best guide. We specialize in assisting you through the entire process of processing Medi Claims Cashless Anywhere – from admission and billing to pre-authorization requests and discharge. As an award-winning Claims Assistance Company, OASIS is committed to providing exceptional support. For more information or assistance, please contact us at 9081 777 123 or support@oasishospitalsolutions.com. Visit our website at www.oasishospitalsolutions.com for further details.“
Important FAQs
Q.1) Is my hospital eligible for cashless services anywhere or everywhere?
Ans: If not excluded or blacklisted by the insurance company or Third Party Administrator (TPA), the hospital is eligible for cashless services anywhere or everywhere.
Q.2) Who do we contact for cashless services anywhere or everywhere?
Ans: For Cashless Services inquiries, contact the Insurance Company for guidance on availability anywhere and everywhere.
or
- Contact at Oasis Hospital Solutions for Cashless Everywhere in Gujarat
Q.3) Does the hospital need to sign an MOU or provide specific documents?
Ans: Oasis helps hospitals complete enrollment documents for cashless services, providing comprehensive guidance for a seamless process.
Q.4) What documents are needed for Cashless Anywhere or Everywhere, and where should we submit them?
Ans: Required health insurance claim documents include:
- Completed and signed insurance claim form
- Patient’s discharge summary or card
- Doctor’s written consultation with receipts
- Stamped and signed hospital bills
- Test results (blood tests, urine tests, X-rays, etc.)
- Prescription bills from pharmacies/hospitals
- FIR or Medico Legal Certificate for accidental injuries
- Any other relevant treatment-related documents.
Q.5) What are the basic guidelines for processing Cashless Anywhere or Everywhere? Provide an overview of the steps and requirements for the cashless process.
Ans:
- Share the Preauthorization Form 24 hours before a planned procedure or within 24 hours for emergencies.
- Send pre-authorization requests to Insurance Companies/TPA/Agency.
- Pre-authorization not received within specified timeframes won’t be considered for “cashless anywhere.”
- After receiving the form, the claims team will notify approval, denial, or request additional information.
- Service inclusion/exclusion depends on insurance policy; providers may adjust based on policies.
Choose Oasis Hospital Solutions for a seamless and trustworthy healthcare transaction experience. Trusted by over 300 hospitals, our platform ensures 100% payment assurance, simplicity, and ease.
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