List of Reasons for Delay in Health Insurance Claims
Health insurance is a troubleshooter during medical emergencies and severe health conditions. Generally, policyholders request claim settlements to the health insurance agency. The claim can come in the form of reimbursement and cashless payment. Medical insurance claim works like a financer for you when you desperately need to settle your hospital and medical expenses. Unluckily user faces delay in claim settlement, which is not cool, and even it poses a risk to the patient’s family to become clueless of no other options of funds. The claim settlement department conducts inspection and adopts strict screening to authenticate the claim application and submitted documents. Now you need to know the reasons behind delaying in claim settlement by health insurance agencies.
Unfinished Pre-Authorization Form
It will help if you comprehend that a pre-authorization form is a compulsory requirement for cashless settlement. Even if you ask your Health Insurance Advisor in Noida, he will also tell you to complete the pre-authorization form before applying for claim settlement. The hospital will provide you that form. Ensure to read the documents cautiously and write all the necessary information accurately with the exact treatment cost. You can also get the assistance of an executive in case you face issues in filling the form. Submit the correct details in the form without errors
Mistaken Identity
Health insurance agencies need authentic identity proofs of the insured person and patient. So it is necessary to hand over the accurate ID proof, including PAN card, Aadhar Card, Voter ID, etc., to the hospital third party admin department. Get clear information about the claim settlement process from your Health Insurance Advisor in Noida Sector 18 at Bima Plus. In case the claim settlement department detects any inconsistency, they can instantly stop the procedure until they validate the correct identity of the insured and patient.
Getting Late in Documents Submission
The health insurance beneficiary must submit the needed documents within the determined time post-discharge from the hospital for reimbursement. If you failed to submit the documents on time, there are high possibilities that the hospital can hold your claim application. However, in some cases, you will get special consideration based on merit. Check out more clarity with Health Insurance Advisor in Noida Sector 37 through Bima Plus.
Transfer of Documents Between Insurance Agency And Hospital
Documents transfer between the insurance agency and hospitals is a time-taking procedure that can also bring late in claim settlement. The claim settlement department for both parties needs to work as per guidelines that may take time. You need to repeatedly follow up with them to prevent yourself from any confusion and trouble during discharge.
Delay in Intimation To The Hospital
If you inform the third-party hospital administration and help desk on time, it will not bother you. This is because timely intimation to the hospital is compulsory in case of medical emergencies or intended hospitalization. But if an insured person doesn’t intimate on time, there are high possibilities that the claim will be on hold.
