The cashless facility can be availed only in network hospitals. As soon as you are admitted at the network hospital, show your health card to the doctor. The hospital will contact the TPA listed in the card to complete the pre-authorization form and forward it to the TPA to estimate expenses. The TPA then reviews the terms of the policy along with sum insured before approving the estimate. You receive treatment without paying anything and the insurer settles the bill with the hospital.
Cashless hospitalization may be planned or emergency. Under planned, you can choose the network hospital from the list and use your health card at the hospital’s insurance desk to complete the pre-authorization form and forward it to the TPA for approval. Once they sanction the eligibility amount, treatment begins. For emergency hospitalization, the process must be initiated within 24 hours of admission into the hospital. The process is the same as planned hospitalization unless the treatment has to start right away when you can deposit the money and claim reimbursement later.