Cashless Hospitalization Process Explained
A simple walkthrough of admission, pre-authorization, query replies, approval, and final discharge billing.
Cashless hospitalization starts when the hospital sends a pre-authorization request to the insurer or TPA. This request includes patient details, diagnosis, estimated cost, policy information, and supporting medical documents.
The insurer or TPA may approve, reject, or raise a query. A query is a request for more information, such as previous records, investigation reports, or clarification from the treating doctor.
At discharge, the hospital sends final bills and reports for final approval. Patients may still need to pay non-payable items, deductions, co-pay, consumables, or costs above policy limits.
Families should stay in touch with the hospital insurance desk and keep copies of important documents.
Information on this platform is for education, consultation assistance, and documentation support. Insurance approval, settlement amount, and timelines depend on insurer, TPA, policy terms, and submitted records.