Understanding Network vs. Non-Network Hospitals
When comparing health insurance plans, the size of the hospital network often becomes a key factor in your decision. People tend to prefer insurers with a larger network because it promises greater access to care. But there are several misconceptions about what “network hospitals” mean and how they impact your claim experience.
Imagine a situation where a family member needs urgent care. In such moments, you rush to the nearest hospital without checking whether it is a “network” one or not. However, for planned treatments, knowing the difference between network and non-network hospitals can save you both money and stress.
What Are Network Hospitals?
Definition and Benefits
Network hospitals are empanelled with your insurer under a formal agreement. They allow policyholders to avail cashless hospitalisation , meaning billing is settled between the hospital and the insurer while you focus on recovery.
How ManipalCigna Collaborates with Network Hospitals
ManipalCigna Health Insurance has over 14000+ network hospitals across India, ensuring accessibility and convenience for its policyholders.
Access to Cashless Treatment and Faster Claims
We also have OPD cashless network of around 37000 hospitals in India, The insurer directly settles the medical bills with the hospital, subject to policy terms and conditions. The process is smoother, with minimal paperwork and trained hospital staff managing insurance approvals.
What Are Non-Network Hospitals?
Definition and Limitations
Non-network hospitals are facilities not tied to the insurer. You can seek treatment there, but you will need to pay the full bill at the time of discharge.
Reimbursement Process and Documentation
If a policyholder avails treatment at such a hospital, they have to pay the bills upfront and later apply for reimbursement. This involves submitting all the necessary documents, like bills, prescriptions, discharge summaries, etc.
Impact on Claim Settlement Time
Because of manual verification, reimbursement claims usually take longer to process compared to cashless claims.
Key Differences Between Network and Non-Network Hospitals
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Cashless vs. Reimbursement Claims
Understanding the Cashless Facility Network hospitals provide direct coordination between the insurer and hospital, ensuring no major upfront costs for the policyholder. - Steps Involved in Reimbursement Claims: Non-network hospitals follow a reimbursement route that requires policyholders to compile and submit multiple documents for claim approval.
- ManipalCigna's Support in Both Scenarios While cashless is seamless, ManipalCigna assists policyholders with reimbursement claims to ensure transparency and timely settlement.
Cost Implications
- Out-of-Pocket Expenses at Non-Network Hospitals: Choosing non-network hospitals often means bearing higher upfront costs until reimbursement is processed.
- How Network Hospitals Help in Cost Management: With cashless facilities, you avoid the strain on savings during hospitalisation.
- ManipalCigna's Role in Minimising Financial Burden: By offering a wide network and streamlined claim approvals, ManipalCigna reduces financial stress for policyholders.
Documentation and Approval Process
- Required Documents for Network Hospitals: Minimal paperwork - ID, policy card, and pre-authorisation forms.
- Documentation for Reimbursement Claims: Bills, prescriptions, discharge summaries, and bank details are mandatory.
- ManipalCigna's Streamlined Approval Process: In network hospitals, insurer and hospital coordinate directly, while in non-network, the policyholder has to handle all paperwork.
ManipalCigna’s Network of Hospitals
Extensive Network Coverage
Number of Network Hospitals Nationwide ManipalCigna’s network includes 8500+ hospitals across India. Access to Top-Tier Medical FacilitiesThese hospitals span metros, towns, and regional hubs, ensuring access wherever you are.
ManipalCigna's Efforts in Expanding NetworkThe insurer continually adds new hospitals to strengthen accessibility.
Benefits of Choosing Network Hospitals
- Immediate Cashless Facility: You don’t have to arrange funds during emergencies.
- Reduced Documentation Hassles: The hospital handles paperwork directly with the insurer.
- Faster claim settlements: Cashless claims are processed quickly than reimbursements
How to Locate a Network Hospital
Using ManipalCigna's Hospital Locator Tool ManipalCigna Health Insurance provides a hospital locator tool on its website where policyholders can check the list of empanelled network hospitals. Tips for Selecting the Right Hospital Always confirm network status before admission to avoid surprises. Contacting Customer Support for Assistance Policyholders can call customer care for guidance on the latest empanelled list.
When to Opt for Non-Network Hospitals
Situations Where Non-Network Hospitals May Be Necessary
- Medical Emergencies in Remote Areas: The nearest available hospital may not be in the insurer’s network.
- Lack of Nearby Network Hospitals: Some smaller towns may not have listed hospitals within reach.
- Specific Treatments Not Available in Network: Specialists or rare procedures may require you to go non-network.
Steps to Take When Using Non-Network Hospitals
- Informing ManipalCigna Immediately: Notify the insurer about hospitalisation to initiate the process.
- Collecting All Necessary Documents: Keep bills, prescriptions, and discharge summaries ready.
- Submitting Claims Promptly: Submit your reimbursement claim without delay to avoid processing lags.
ManipalCigna’s Assistance with Non-Network Claims
- Guidance Through the Reimbursement Process: Dedicated teams help with claim documentation.
- Ensuring Timely Claim Settlements
- ManipalCigna works to resolve claims promptly, even in non-network cases.
- Addressing Policyholder Concerns: Assistance is provided at each step to reduce stress during treatment.
How ManipalCigna Supports Your Healthcare Journey
- Commitment to Quality Care and Customer Satisfaction: Ensuring that policyholders receive timely treatment and reliable support.
- How ManipalCigna Keeps Policyholders Updated: Regular updates about changes in the hospital network and policy features.
- ManipalCigna's Transparent Policy Information: Clear communication on inclusions, exclusions, and claim processes.
- How ManipalCigna Assists in Documentation: Step-by-step guidance for pre-authorisation and claim submissions.
- ManipalCigna's Wellness Programs: Beyond hospital care, ManipalCigna offers preventive health check-ups and wellness initiatives.
Conclusion & Takeaway
It is essential to understand the distinction between a network and a non-network hospital for effective healthcare management. In emergencies, when you do not care about money but only the well-being of a family member, you might ignore the distinction between the two categories. However, when the illnesses are routine and manageable, you should consider using a network hospital because it offers a cashless facility, and there is no pressure on you to handle any paperwork associated with the treatment.
FAQs
Can I choose any hospital for treatment?
Yes, you can choose any hospital for treatment. However, choosing a network hospital gives you the benefit of cashless treatment, while non-network hospitals require you to pay upfront and later apply for reimbursement.
How do I know if a hospital is in ManipalCigna's network?
You can check ManipalCigna’s hospital locator tool on their website or app. Always confirm with the hospital before admission, as the network list may change over time.
What Happens If I Receive Treatment at a Non-Network Hospital?
You will need to pay the bills upfront and then submit the required documents (bills, prescriptions, discharge summaries) to the insurer for reimbursement. Claim settlement may take longer compared to cashless treatment.
Are There Any Additional Costs at Non-Network Hospitals?
Yes, non-network hospitals may lead to higher out-of-pocket expenses since you pay first and then wait for reimbursement. Certain charges may also not be covered under your policy terms.
