Can you get a Cashless Facility for Daycare Treatments? If yes, how?

An obstacle, in the pursuit of your life goals, is often health-related. Sometimes, we feel that we are too busy to seek medical help. We only visit a doctor when our health deteriorates and we can no longer deal with the pain. This is where health insurance comes in clutch.

Medical insurance plans are gradually becoming the standard, with many Indians purchasing them to cover the exorbitant expenditures of treatment. While traditional health insurance plans cover significant operations and hospital admissions, your medical insurance coverage may also include shorter, daycare treatments. This blog will provide a guide on cashless daycare treatments in health insurance policies.

What are Daycare Treatments?

A daycare treatment is a surgical or healthcare treatment that used to need a lengthy hospital visit but may now be finished in less than a day i.e. 24 hours.

Daycare operations are procedures or surgeries that, because of developments in technology and medicine, no longer need extensive hospitalizations. Nevertheless, this does not stop these procedures from being a financial burden on the patient. In reality, the whole expense of these operations, including medical testing and prescriptions, are usually rather high.

Cashless Facility for Daycare Treatments

Most network hospitals is now providing the facility of cashless treatment, where the medical bills are paid directly to the hospital without having to pay any extra money. Most daycare operations and healthcare treatments are usually planned ahead of time. Patients can simply use the cashless treatment service at any hospital in the network by alerting their insurance provider within the time-frame indicated.

Which Daycare Procedures are available in Cashless Facility?

Health Insurance policies cover a wide range of daycare operations, and the majority of them accept cashless options. It is, however, entirely dependent on the insurance provider.

The following are the most frequent processes provided in cashless facilities:

Organ Procedure
Eyes
  • Cataract surgery
  • Extraction of a foreign substance
  • Incision of the cornea
  • Tear duct procedures
  • Incision of the eyelid
  • Surgery to correct entropion and ectropion
Sinus and Nose
  • Aspiration of the nasal sinuses
  • Nasal concha surgery
  • Removal of foreign substances
  • Other surgeries involving the nose
Ears
  • Stapedotomy
  • Stapedectomy
  • Auditory ossicles surgical procedures
  • Tympanoplasty
  • Middle ear surgery
  • Middle ear reconstruction
  • Inner ear incision
  • Other inner ear surgeries
Tongue
  • Tongue reconstruction
  • Glossectomy
  • Other tongue surgeries
Bones
  • Surgery for a torn ligament and torn meniscus.
  • Trauma and orthopedic surgery
  • Tendon fractures and sutures
  • Surgery for a dislocation.
  • Other bone and joint operations
Skin
  • Skin transplantation and skin regeneration
  • Skin chemosurgery.
  • Skin incision
  • Subcutaneous tissue incision
  • Diseased skin excision
  • Diseased skin Excision
Face
  • Plastic surgery
  • Mouth, jaw, and facial incisions
  • Other operations involving the face and mouth
Others
  • Chemotherapy
  • Cancer radiotherapy
  • Lithotripsy
  • Haemodialysis
  • Coronary angiography

 

Cashless Claim of Health Insurance

Finding out the procedures for notifying the insurance company and filing a claim is one of the most important tasks to do when choosing a medical insurance plan. It is also critical to notify the insurance firm of the hospitalization within the time frame specified. All of these actions will assist to avoid any last-minute fiascos.

To use your medical insurance for daycare services, you must go through the same claim procedure as you would for in-patient hospital stay coverage in a conventional medical plan. The cashless facility is available at network hospitals for any scheduled or emergency care.

It is straightforward, and you do not need to make any initial preparations. You can look forward to receiving the facility at any network hospital that has been approved by the insurance company. Notifying the insurance desk, filing a pre-authorization application, and providing the health insurance card or any other needed documentation are the first steps of cashless admission.

Note:

  1. A cashless facility for daycare treatment is only available for planned treatments. For emergency treatments, you would have to apply for reimbursement only as the regular cashless Turn-Around-Time (TAT) is usually 24 hours or higher.
  2. To avail cashless facility for a daycare treatment, you need to be “hospitalised”. Just that the tenure for “hospitalisation” is less than 24 hours. It is an in-patient treatment and is usually not done at the OPD (out-patients department) of the hospital.

 

Reimbursement procedure:

if the cashless procedure is not availed due to any reason, it is always be filed as a reimbursement. In such a case, there is no need to admit yourself to any of the network hospitals. It can be done from any hospital, except the “black-lusted” ones. The documents need to be submitted along with your KYC documents and bank account details for the reimbursement claim.

Conclusion

In a positive gesture, Insurance Regulatory and Development Authority (IRDA) has pushed insurance companies to introduce more daycare based policies, pointing out that non-hospitalization charges are nearly twice as expensive as hospitalization costs. He noted that advances in healthcare technology have enabled numerous therapeutic regimens to break free from the 24-hour hospitalization burden.

Jan 10, 2022
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Gayatri Prabhu, Head-Digital Business at Mahindra Insurance Brokers Limited (MIBL) is one those few digital leaders who has the width and depth that is required to execute an ROI driven holistic digital strategy. She cuts through the noise, identifies the critical levers and leads her team to successful execution of the defined strategy. Her core mantra to win new and retain existing customers is: understand the consumer behavior and craft experiences around it.

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