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Claims
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FREQUENTLY ASKED QUESTIONS:: 1. Are there any charges by the hospital, which are not reimbursable and hence have to be paid by me even after "Cashless Service" has been authorized for treatment in the network hospitals? Ans:: Yes. There are quite a few charges, which are not reimbursable and have to be paid by you even though you have been authorized for "Cashless Service" at the Network Hospitals. Some of those charges are enumerated below:
- Registration/Admission Charges.
- Attendant/Visitor pass charges.
- Service charges not forming a part of the room rent.
- Charges for TV, Laundry etc.
- Telephone/Fax charges.
- Food and Beverages for attendants and visitors.
- Toiletries etc.
- Stationery, Xerox or certifying charges
2. Does denial of cashless facility mean final denial of the claim? Ans:: "Cashless Service" may be denied in some of the situations as listed below.
- In case of any doubt in the policy terms with respect to the present ailment.
- If the information sent to TPA is insufficient to confirm coverage.
- The ailment/condition etc. not being covered under the policy.
- If the request for preauthorization is not received by TPA in time.
However, denial does not mean denial of treatment and does not prevent you in any way prevent you from seeking necessary medical attention or hospitalization. Hence, you may please submit the claim documents on reimbursement basis after the completion of treatment. Upon receipt of the complete documents we shall let you know the final decision based on terms and condition of the Policy. 3. Can Reliance facilitate me with cashless in Non-netwrok hospital, in case I cannot take admission in Network hospital due to some reason? Ans:: In such case, we would request you to please notify as soon as possible with full details of the hospital where you will be admitted along with disease, estimate cost, tentative date of hospitalization, tentative duration of hospitalization. We shall try to facilitate you with cashless, if the non-network hospital accepts the authorization from us or else our services will be restricted to claim processing on reimbursement basis only.
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