The pandemic has reaffirmed the importance of healthcare and individuals have started paying more attention to understanding the different aspects of health insurance. While considering purchasing insurance, the obvious focus is usually on coverage benefits and related features. What you miss, however, is what costs are paid for and what is excluded when billing.
There are many non-medical costs associated with hospitalization, which are generally not covered by health insurance in India.
Health insurance accrued expenses
The most common no-payment expenses not covered by traditional health insurance products in India include consumables such as syringes, gloves, dressings and bandages, as well as essential items such as oxygen masks.
Additionally, some hospitals may charge patients administrative costs that are not covered by traditional health insurance, such as medical records and registration. Then there is the attendant fee, whose cost of employment may not be covered by health insurance.
It may look cheap, but there are about 68 items that can make up a large sum of money on an overall hospital bill. Such items typically accounted for 5-15% of the bill, and in certain cases reached 20-25% of the bill, especially during the COVID-19 pandemic.
What does 100% bill pay in health insurance mean?
The term “100% bill-paid” means that the insurance company pays the full amount of the policyholder’s hospital bill, subject to the insured amount, without the policyholder’s out-of-pocket medical costs. means
What can insurers do to ensure 100% bill payment in the healthcare ecosystem?
Within the healthcare industry, there are many differences regarding protocols for the use of consumables.
Insurance companies and hospitals should work together to agree on standard procedural-level protocols for utilizing such items.
Some insurers may be willing to cover such items given their pricing considerations given the predictability of such costs. has taken steps to cover some consumables by creating lists specific to each company. , is a good start to provide customers with a better experience.
In addition, it guarantees peace of mind for customers not to have to worry about different headers that are covered and not covered.
In conclusion, 100% bill payment is a valuable benefit that comes with cashless health insurance. This means policyholders don’t have to worry about paying hospital bills out of their own pocket.
However, before purchasing health insurance, it is imperative that you read the policy carefully and understand the terms. It helps you make informed decisions and choose policies that meet your healthcare needs.
With the ongoing purpose of supporting customers on their end-to-end medical journey, insurers seek best-effort coverage of up to 100% of their bills by defining reasonable expenditures for procedures or hospitalizations. We need to collectively approach how to
– The author is Vice President – Retail Health, ACKO. Views expressed are personal.
Disclaimer:The views expressed in this article are those of the author and do not represent the position of this publication.
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