If you have filed a claim for health insurance plans even once in your life, you must be aware of the intricate claim processes. One of the most significant factors that determine if your claim is going to be approved or not is the stipulated time frame. Most insurance plans offer you claim compensation only when you get the insured person hospitalised for more than 24 hours. However, for those instances when the patient was hospitalised for less than 24 hours, insurance companies generally reject the claims.
This blog discusses those rare instances when the insured person gets hospitalised for less than a day’s time and yet manages to get compensated for the same by the health insurance company.
Is It Possible To Claim For Treatments That Require Less Than 24 Hours Of Hospitalisation?
Yes, it is possible to claim for treatments that require less than 24 hours of hospitalisation. Day Care treatments are the ones for which you can claim compensation from the health insurance company. They consist of a set of treatments for which the patient does not need to be hospitalised for multiple days.
What Is Daycare Treatment?
There are certain medical procedures as well as surgical operations that are carried out under the direct influence of local or general anesthesia. Such treatments take place in a hospital or daycare centre. Advance technological development and easily accessible equipment and tools help in carrying out these medical procedures in less than 24 hours of time.
Complete List of Daycare Procedures
- Tongue: Reconstruction of the tongue, glossectomy, and other minor operations of the tongue
- Eyes: Ectropion, entropion, cataract operation, eyelid and corneal operation, corrective surgery, tear duct operation, removal of foreign body
- Ear: Tympanoplasty, stapedotomy, incision of the inner ear, operations on the auditory ossicles, operations on the middle ear, other operations of the inner ear, stapedectomy
- Bones: Dislocation surgery, orthopedics and trauma surgery, ligament tear and meniscus tear surgery, suture on the tendon, joint and bone surgery, fractures etc.
- Face: Incisions to the mouth, plastic surgery of the mouth, minor operations to the face and mouth
- Skin and Subcutaneous tissues: Excision of diseased skin, chemosurgery to the skin, excision of subcutaneous tissues, skin transplantation, skin restoration
- Other operations: Lithotripsy, radiotherapy, haemodialysis, coronary angiography, chemotherapy and so on
When you buy a health insurance plan, make sure you have these daycare treatments mentioned in the policy papers. Otherwise, you won’t get any coverage for the same.
Claim Filing And Settlement For Daycare Procedure
Just like other claim filing procedures, you need to be careful and vigilant while filing a health insurance claim for daycare treatments as well. Generally, the claim registration process remains the same.
If the insured patient has been hospitalised for less than 24 hours and the daycare treatment comes under the procedures to be covered in your health insurance policy paper, then you need not fulfil any special condition to claim coverage from the health insurance company. Just make sure that you get the patient admitted to a network hospital. Carry all the necessary documents and share the same with the insurer. They will get the documents verified and then clear the bills with the hospital authority directly.
Next time you undergo a daycare treatment, do not worry about the expenses, as your health insurance company will get it compensated if you have chosen the right plan. The catch is to buy a health insurance policy that covers as many daycare treatments as possible. This increases the chances of coverage and compensation, thereby reducing your financial woes.