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A health Insurance policy equips you to get the best healthcare treatment without worrying about the huge costs payable at the time of discharge. Therefore knowing about the claim process is an essential piece of information that the insured individual should be aware of at all times.
When the insured individual provides their health insurance details to the respective hospital, he/she begins to receive treatment. Upon discharge, the hospital will forward the medical bills to the designated health insurance company. The company will then audit the expenses and settle the outstanding payment due to the hospital. This process is hassle-free for the insured as the payments are between the hospital and insurance company.
In the reimbursement claim process, the insured individual who has been admitted to a certain hospital pays for the entire treatment until discharge. Once the insurer has paid for the treatment and hospitalization costs incurred, he/she have to make a reimbursement claim to the particular insurance company. The insured individual will have to provide original bills of the hospital to the health insurance and claim reimbursement. The insurance company will audit the claim and will then decide to approve or reject it. On approval of the insurance company, the claim will be made to the policyholder. The insurance company will notify the insured individual in case the claim has been rejected.