Network Of Hospitals How It Impacts Your Health Insurance

Network Of Hospitals: How It Impacts Your Health Insurance?

Having a medical emergency is one of the biggest uncertainties of life. And the greatest way to remain financially prepared for it is through health insurance. Nevertheless, among the different advantages that health insurance gives, cashless medical care is a noteworthy one.

This implies that one can receive the appropriate care when needed and not have to pay for it. The policyholder only needs to visit one of the insurer’s hospitals to receive treatment, and the procedures will be handled there. However, this advantage is applicable only in a network hospital. 

This article will briefly discuss what exactly is a network hospital and how it affects an individual’s health insurance plan. 

Continue reading to know more!

What Are Network Hospitals?

‘Network hospitals’ are the hospitals that are available for cashless treatment. The phrase “network hospital” in the context of health insurance refers to a partnership or affiliation with your specific insurance provider to offer cashless hospitalization services to the insured. 

Due to this feature, the insurance provider guarantees to its policyholder that he or she will not be required to pay cash at the time of admission to the hospital to receive high-quality care. Arranging money at critical junctures like medical emergencies, where every minute is precious, can be tedious and time-consuming. The primary advantage of choosing a health insurance provider with network hospitals is that the entire process, from hospital admission to claim settlement, becomes hassle-free and there is no requirement to get anxious about cash supply.

Impacts Of Network Hospitals On Health Insurance

Having the feature of network hospitals greatly impacts various aspects of health insurance. The three major aspects are discussed below:

Impact On Treatment:

In a non-network hospital (the hospital that has no tie-up with the insurance company), no cashless treatment is offered. The policyholder needs to pay bills out of his/her own pocket. This can not only create unnecessary inconvenience but also put financial strain on the entire family. 

However, with a network hospital, one can avail of cashless treatment, subject to the policy terms and conditions. This allows the policyholders and his/her family members to focus on the treatment and get well soon rather than indulging in the inconvenient task of arranging cash for the treatment. Thus, network hospitals do affect the treatment process of the insured member or the policyholder. 

Impact On Formalities:

A non-network hospital’s treatment process is filled with formalities. This includes paying the hospital bills, gathering proof of medical treatments, completing the reimbursement claim form, and sending the insurance company the discharge summary and hospital bills. This procedure could be bothersome and tiresome.

These formalities can be reduced by choosing a network hospital. The policyholder is simply required to provide his/her health insurance card and the hospital and the insurance company will take care of every formality from admission to discharge and claim settlement. 

Impact On Insurance Claim:

In the case of non-network hospitals, the claim payout is based on the insurance provider and the supporting documentation given by the policyholder. The policyholder must submit a reimbursement claim to the insurer after being released from the hospital to get the money he/she has spent in the hospital. The insurer will examine all of the receipts and documents and will approve everything it deems to be accurate and acceptable. Thus, there is a substantial likelihood of financial loss. 

However, one needs not to be concerned about the claim settlement procedure when receiving treatment at a network hospital. The insurance will speak with the hospital and handle all the paperwork directly. The risk of financial loss here is much lesser as compared to the non-network hospital since the process is carried out directly. Due to the factor of convenience and finance, cashless claim settlement is far better than reimbursement claim settlement.

Does Network Hospitals Affect Your Health Insurance Premium?

No. Choosing a health insurance provider with a ‘network hospital’ feature does not affect (increase or decrease) the premium of your health insurance plan. But it is the claim process, number of formalities, and treatment, as mentioned above, that gets affected.

Why Is It Important To Choose A Health Insurer With Larger Number Of Network Hospitals?

It is crucial to choose a health insurer with a higher number of network hospitals because the policyholder can get a wider scope in nearby or far regions. The higher the number of network hospitals, the lesser the policyholder will have to worry about to look for a good one in an emergency. It is equally important to review the list of hospitals in addition to having more cashless insurance hospitals in the insurer’s network.

Final Words

If you have a health insurance plan, it is always preferable to select a network hospital for any type of medical operation or emergency. You can receive treatment more easily and with less difficulty with the cashless claims feature of such hospitals. In addition to saving time, it also eliminates the hassle of double-checking bills before paying them. 

However, maintain a list of nearby network hospitals in case of need. To get the best yet most economical treatment, keep in mind to consider price, service, and quality when making your choice.

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