Maybe you already know yes, that filing a health insurance claim is much different from buying an insurance product. Does Ga believe? Just try your post on the online media with the topic "Finding the best health insurance". About an hour later, your post was already deployed insurance agents from various companies, sugar tubs found ants.
Ok, one thing that needs to be in the matter is that health insurance claims GA hard, as long as according to the Coauthor. Hence, be a wise consumer, always look at what you sign.
One of the most important points you should understand from your health insurance policy is the method of claim. The claimed method is generally divided into two types of health insurance:
- Cashless
- Reimbursements
Cashless
The cashless method is a method where you don't have to spend money to make an insurance claim. How? Instead of being confused, let's take a look at examples of insurance claims with cashless methods.
Rizal, 25, suffered a motor accident that caused his hand to break. So that night, Rizal went to a hospital that has a cooperation program with its insurance provider.
With cashless insurance, Rizal just needs to register by completing the personal data and swiping the insurance card on the machine provided. After that, Rizal could breathe a sigh of relief because he did not have to worry about going out much money for his treatment.
Is it good? EITs, there are a few things you should understand before you can make an insurance claim as smoothly as Rizal. We cover yes each of their shortcomings and strengths.
(+) No need to exit money
The cashless method eliminates the need for policyholders to have the required cash in health emergencies like this. Because the claim is done directly in front, the hospital bill is already borne by the insurance from scratch.
(+) Can go straight
If you are in a hospital that already has a cooperation program with an insurance provider, you can go straight in without having to bother completing a variety of forms. Just complete personal data, swipe insurance cards and jump in.
Unless you have an accident that interferes with foot function, then you will get in with a wheelchair. It cannot be overstretched.
But even though it sounds like the easiest method, cashless also has its own drawbacks. Like.
(-) Limited Hospital options
If you peruse the cashless advantage above, you will be instantly aware of its shortcomings. Yes, not all hospitals provide a cashless insurance claim facility. And not all who provide cashless insurance providers have a cooperative program with hospitals that you will occupy.
Reimbursements
This is a method that existed a long time before the cashless system was introduced. With this traditional method, you still have to bear your own whole hospital bill. Later, you just have to claim your insurance provider by including all the bill payment receipts.
For example, let's get a Rizal accident again. It's a pity Rizal, but this is the price he has to pay for understanding all readers.
This time, he got into a hospital that didn't provide the cashless feature. Thus, the previous automatic Rizal must already have a certain amount of emergency that he could use for such a situation. He went in and out like the patients in general. This means he has to pay the hospital bills from his own cob first.
Then, Rizal will contact the insurance provider to claim by including all the proof of the bill he paid in the hospital. If accepted by the insurance, all Rizal's money will be reimbursed.
It seems not a tough choice when compared to the cashless that is so easy. However, the reimbursement method has its own advantages and disadvantages, such as.
(+) Not limited to certain hospitals
Because the focus of the reimbursement method is the replacement of the patient's money that has been paid to the hospital, then this method is not limited to certain hospitals. Rizal can have medication anywhere in the future, he can show signs of payment of hospital bills.
(-) Must provide emergency costs
Unlike cashless methods, reimbursements depend on the patient's ability to pay in advance all their hospital bills. Automatically have to reserve the money that will later be used to pay. Without the money, the holders of the GA insurance will be able to reach the insurance claim because it has been held in bills that can not be paid.
(-) Longer processes
When with the cashless method The bill is automatically borne by insurance without a lengthy process, then the reverse reimbursement. Since the initial paid by the patient, it is necessary to include very complete information about the chronological and the bills that have been paid.
Then the claim will be checked thoroughly by insurance before it is approved for replacement. Insurance claims may fail to approve if the insurer finds any discrepancy in the claim.
Whether it's cashless or reimbursements, there's one thing you can do to streamline your claims. The reporting of claims made as soon as possible after the incident will facilitate the process because the evidence required by the insurance is still ' fresh '.
And don't forget, whichever method you use, adapt it to the insurance policy. Do not let you make claims that are more than what is covered in your insurance policy.
If the insurance cover only the cost of hospitalization of the room, do not ask the cost of medication replaced. Later even complicated and the edges claim GA so fulfilled.
Whichever method you use, your priorities are your health. Choose the hospitals and services that provide the best care and suit what you need.
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