A Step By Step Guide To Claim Process When You Have Two Health Insurance Policies - PDF document

A Step By Step Guide To Claim Process When You Have Two Health Insurance Policies When filing health insurance claims, having access to several different insurance plans might be helpful. U sing several benefits, broadens the scope of coverage , gives policyholders more options and can result in significant cost savings. You want the best healthcare facilities and treatment for several serious ailments while buying health insurance . To protect your family from any unplanned hospitalizations, you must have strong health insurance coverage. If one of your health insurance policies is insufficient, you can claim both of them if you have two. Getting an estimate from the hospital beforehand is the best method to determine whether you need to use both plans. You'll need to plan ready to employ two policies once you reali z e this and reali z e that the sum insured in one policy might not cover the total expenditure. The best way to utili z e both of your health insurance coverage is as follows. How to claim health insurance from multiple insurers? Can I file a claim with two insurance companies if I have two health insurance policies, one through my employer and the other through my policy? Yes, that is the response. You must file a claim with the first insurance provider for the cost of medical care to submit claims to several health insurance plans. The next step is to get the summary of the claim settlement, verify the hospital bills, and contact the second insurance provider to handle the remaining costs. P rocess to claim health insurance from two or more policies 1 . Cla i ming from the first health insurance policy Multiple health insurance policies may be used in one of two ways for cashless claims. The first and most well - known option is the one where you obtain the claims settlement summary. You must obtain attested copies of the bills after this is finished. Now that the remaining sum is still owed, you can go to the second insurance provider and ask for repayment. If you're fortunate enough to receive treatment costs that are precisely stated, you can complete both of the authorization forms as required. Each of the insurance companies will receive paperwork from the hospital. Insurance providers will settle the amount with the hospital directly based on this. How does a cashless claim process work? 1) You must first check with the hospital desk to see if payment can be made without cash and obtain a list of all the necessary paperwork (such as a copy of your insurance policy or card, a PAN card, identification documentation, etc.). Keep a copy of these documents on email for ready access, since the majority of hospitals will also accept them online. 2) Pre - authorization is the term for the hospital's request that the insurer issue an initial approval of the treatment expense on your behalf. This pre - authorization may be delayed if there is a holiday or if the insurer's office or hospital desk is closed, and you may then need to pay a deposit to be admitted. 3) Follow up with the insurance desk to submit all the bills and paperwork to the insurer as soon as you learn the date of your discharge. 4) Once all the documentation is completed, it typically takes 2 to 6 hours for the insurance to give its final approval. 5) If the final approval is delayed, you can pay now and request reimbursement later, or you can wait until your claim is authori z ed. 6) Your claim's approval or denial will be indicated on a claim settlement summary that the insurer will provide to you (and if approved, what part of the claim is approved too). 7) This document will provide a thorough breakdown of all the costs you incurred for your treatment, including both those that have been approved and those that have not. Given that you still have one claim to make, this is an extremely critical step to take. H ow does a reimbursement claim process work? 1) Before being admitted to the hospital, you must notify the insurer within 24 hours. (for scheduled hospitalizations, a day before) 2) Once you have gathered all the necessary original paperwork, submit it to the insurance company with a properly completed claims form. 3) Whenever the insurer asks a question or demands a missing document, make sure to respond as soon as you can. 4) The insurer will provide you with a claim settlement summary that includes information on the line items that were authori z ed and those that were rejected, as well as the reimbursement amount and deductions that were made. 5) The bank account you specified on the claims forms will be credited with the reimbursement amount. 2 . Cla i ming from the second health insurance policy You will need to make another claim from your second policy based on what is and is not covered by the first claim. This will always be accomplished through payment. The insurer will return all the paperwork and unpaid bills once the claim under the initial insurance has been resolved. However, they might choose to withhold the original bills and receipts that they have paid. You must now provide the second insurer with three items when you apply for a reimbursement claim under your second policy: 1) copy of the bills that the first insurance submitted and paid. 2) copies of the original invoices that the initial insurer did not pay . 3) Received a claim settlement report from the initial insurer.