Hospitalization, Claims and Expenses: Things You Should Know

As humans, we are bound to fall sick and get treated. We may even get hospitalized at some point of time. As a person who may be covered under a health insurance policy and opting for hospitalization, these are some basic things you should know about hospitalization, claims, and expenses.

Read on to know some of the basics of hospitalization.

Hospitalization

Hospitalization can be of two types:

  • Planned hospitalization
  • Emergency hospitalization.

Planned hospitalization happens when you have ample time to plan your admission to the hospital. For example, if your doctor advises a surgery for hernia anytime within a couple of weeks, you have time to plan your hospitalization. Emergency hospitalization happens typically in case of emergencies such as domestic accident or a road accident. One cannot plan such a hospitalization.

Benefits of planned hospitalizations

If you are aware of the fact that you or your family members require hospitalization in the near future, you can send prior intimation to Medi Assist to plan your hospitalization. Not only does this ease the admission and pre-authorization process, but it also helps reduce your overall cost of treatment wherever possible.

Once Medi Assist receives the intimation, we will help you plan everything including choosing a network hospital, opting for discounted packages, if available, and planning for cashless hospitalization. Here are the advantages of a planned hospitalization:

• You get a green-channel hospitalization which means that the hospital is aware of your impending admission and your wait time on the date of admission is significantly lesser.
• The Medi Assist executive helps you compare tariffs and facilities at various network hospitals so you can make an informed choice.
• You have the benefit of opting for discounted packages, negotiated by Medi Assist exclusively for our members, along with the benefit of cashless admission, wherever applicable.
• Even if your policy places a cap on your hospitalization expenses you can reduce your out-of-pocket expenses by choosing the discounted price available to you as a Medi Assist member.

Hospitalization expenses

Expenses associated with hospitalization can be classified as follows:

Pre-hospitalization expenses: When you’re unwell, you will most likely consult a physician first, who gets relevant investigations done before advising hospitalization. Such medical expenses incurred before hospitalization are called pre-hospitalization expenses.
Hospitalization expenses: All expenses incurred as part of your hospital stay as an in-patient can be termed as hospitalization expenses.
Post-hospitalization expenses: Some part of your treatment may extend beyond your hospitalization. It may involve follow-up visits to the doctor, prescription medication, further investigations, etc. Such medical expenses are called post-hospitalization expenses.
Domiciliary hospitalization expenses: This typically includes expenses related to domiciliary hospitalization – at-home medical treatment for more than three days for cases which in the normal course would require hospitalization. The exact circumstances / terms / exclusions related to domiciliary hospitalization would be spelled out in your policy document.

Apart from hospitalization expenses, your health insurance policy may also cover pre- and post-hospitalization expenses, and offer a cap for domiciliary expenses.

Claims

Depending on the situation and your policy coverage, you can make two types of health insurance claims:

Cashless: The essence of cashless hospitalization is that the insured need not make an upfront payment to the hospital at the time of admission. You may not have any out-of-pocket expenses towards hospitalization in this scenario. Cashless hospitalization can be availed only at a Medi Assist network hospital and upon approval of your pre-authorization application.
Reimbursement: A reimbursement claim is one where you pay all the expenses related to the hospitalization of the insured and claim a reimbursement of your expenses after discharge. Reimbursement claims may be filed in the following circumstances:
– Hospitalization at a non-network hospital
– Post-hospitalization and pre-hospitalization expenses
– Denial of pre-authorization for cashless facility at a network hospital.

Visit our website, www.mediassistindia.com, for the updated list of network hospitals.

Your Third Party Administrator: What You Should Know

If you are covered by a health insurance policy, you will be allocated a third party administrator or TPA by your insurance company. However, most people are unaware of who a TPA is or what a TPA does. Here is what you should know about the third party administrator.

• If you are reading this, this means that you have probably been assigned Medi Assist as your TPA for health insurance benefits managed by your organization. As a member of Medi Assist family, you are eligible for hassle-free health care insurance claims administration.

• What this really means for you is that, if you or any of your family members is covered under the insurance policy, we handle all the paperwork related to your claims. Wherever possible, we give you the benefit of cashless hospitalization; and we ensure that your claim is settled at the earliest.

• As a member of Medi Assist, you are not only entitled to hassle-free claims, but also several other health benefits.

• However, you should understand that TPAs are not the same as insurance companies.

What a third party administrator (TPA) does

A TPA is appointed by your insurance company to process your claims. This means that whenever you raise a claim for hospitalization for yourself or any of your family members covered under the policy, a TPA processes these claims.

What a TPA does not do

• Decide who is covered and what ailments/procedures are covered under your policy. Your insurance plan dictates these.

• Control your policy terms and conditions. Your insurance policy is developed by your insurance company.

• Decide admissible/non-admissible expenses. Your insurance policy dictates that.

• Approve/disapprove claim without reason. TPAs process claims strictly based on your policy terms and conditions.

6 Steps to Enjoy Host of Wellness Services

wellness checkHealthcare goes beyond in-patient hospitalization. It includes eating healthy and living a healthy life. An important part of maintaining good health is getting a periodic health check, regular lab tests and scans done. But running around in search of these services may be quite confusing and time-consuming.

How would it be if you could access a world of healthcare and wellness services on your palm? And how would it be if you can obtain them as a personalized package? Now, obtain access to a host of health and wellness services including annual health checks, specialist OPD appointments, lab tests and investigations, and much more through just a click.

Here is how you can obtain these services

1. Go to your MediBuddy app or the MediBuddy online portal

2. Click the ‘Wellness’ tile

3. Select the type of wellness program and package you want

4. Select your preferred network medical center

5. Select your preferred date and time

6. Book your appointment.

It is as easy as that. So, just pick up your phone or laptop and opt for your required health service today.

E-Card: An Efficient Way of Identifying Beneficiaries

ID cardDid you know that carrying a Medi Assist card is mandatory during your hospitalization? A Medi Assist card gives the hospital a confirmation that your insurance company has appointed Medi Assist as your TPA. However, carrying a physical card is often a challenge. A physical card gives confirmation of only one beneficiary in the family who is covered by Medi Assist. There is no guarantee that the beneficiary will carry a copy of the card while getting admitted to the hospital. Another challenge is that the card can either get lost or deteriorate due to wear and tear. Moreover, why do you want to carry around a physical card when you can carry an E-Card?

The Medi Assist E-Card helps you in carrying the details of all the beneficiaries of the insurance policy on your phone, instead of carrying individual physical cards. All you need to do is to flash the E-Card on your MediBuddy app upon request at the insurance desk in the hospital at the time of admission.

How can you do this?

Obtaining a Medi Assist E-Card is very simple. You can do it in two ways.

1. Logon to ecard.medibuddy.in and click ‘Download E-Card’.

2. Enter your Medi Assist ID/Employee ID/policy number or your claim ID.

3. Fill the other mandatory fields and click ‘View’ to verify and confirm your details.

4. You can now download the E-Card.

5. Alternately, go to your MediBuddy app. Click the ‘E-Card’ tile and enter your details. You can now view the E-Card on your app.

So, switch to a more efficient way. Download your E-Card today.

Medi Assist Launches its Portal for Retail Policy Holders – me.medibuddy.in

MediBuddy retail

Dr. S. Chiranjeevi Reddy and Satish Gidugu at the launch of me.medibuddy.in, Medi Assist’s portal for retail policy holders

January 29th 2016 was a monumental day for Medi Assist with the launch of me.medibuddy.in, the portal by Medi Assist aimed at retail policy holders. The MediBuddy retail portal aims at giving retail policy holders complete charge of their health benefit management and give them access to various self-help features.

Dr. S Chiranjeevi Reddy, DGM of New India Assurance launched the MediBuddy portal for retail policy holders. Also present during the launch were Ms. Neerja Kapur, Regional Manager, Mr. JK Rao, Health Manager and Dr. Sunil Nakka, New India Assurance. The MediBuddy retail portal is the first portal in the country to provide retail policy holders complete access to their health benefits.

Medi Assist has set another precedent in the industry.

me.MediBuddy.in: The Portal That Puts You at The Centre of Our Universe

If you are serviced by Medi Assist under your group insurance policy, you may have already experienced our MediBuddy online portal and app. However, if you are a retail policy holder, you will not be completely exposed to the MediBuddy online portal due to limited access. As part of group policy, you are already assigned user credentials which you can use to gain access and manage your health benefits and services. However, as a retail policy holder, you do not have the necessary credentials to gain access. This means that you have no control over how you manage your health benefits.

Now for the first time in the industry, retail policy holders who are serviced by Medi Assist can claim access to their own online portal.

Welcome to me.medibuddy.in, the portal that empowers every retail policy holder to take full charge of their health benefit management and give them access to various self-help features.

How can you do this?

Claiming your online portal is a 3-step simple process. Simply follow the steps given below.

1. Identify yourself

a. Visit our online portal me.medibuddy.in.
b. Enter your Medi Assist ID (MAID) or your health insurance policy number.
c. Enter your full name as mentioned in your policy document and your date of birth in the DD-MM-YYYY format.
d. Click Identify. MediBuddy identifies you and retrieves your basic profile information.

2. Complete your profile

a. Click the pencil icon to edit your profile.
b. Do enter your correct mobile number and email ID. Your secure one-time password (OTP), which is mandatory to confirm your login, will be sent to them.

3. Claim your preferred login!

a. Create your own account with your preferred username and password and sign up!
b. You will receive the OTP to your registered email ID and mobile number. Use this OTP to confirm your profile and claim your preferred login.
c. You can then use these credentials to login from the next time onwards.

The me.Medibuddy.in advantage

• With me.medibuddy.in, you have the freedom to create your own personalized credentials.
• Find our network hospitals close to your preferred location.
• Maintain your health records online and gain access to several healthcare and wellness services such as E-Card, prescription medicine and many more from the end of your fingertips.

With me.medibuddy.in, you can completely change the way you go for cashless hospitalization. Try our eCashless service to gain a pre-authorization well ahead of your hospitalization.

So, try me.medibuddy.in now and gain control over all your health benefits and wellness!!

4 Easy Steps to Speed-up Your Reimbursement Claim Settlement

health insuranceClaiming reimbursement for hospitalization may not be a straightforward task as there may be several challenges involved in processing your claims. There may be times when you may be required to submit additional details or documents, and additional information on the treatment. Moreover, the claim processing begins only after all your documents have been received in full. The time taken during the entire process can be stressful.

How would it be if you could enjoy a faster settlement of your reimbursement claim? Would it reduce your worries? Medi Assist can help you in doing this. All you need to do is intimate us of your upcoming claim online before the hospital discharge and upload your documents online on discharge. An advance notification of a reimbursement claim helps us to be ready, and uploading your documents online helps us start working towards your claim processing immediately.

How do you fast-track your reimbursement claim?

Fast-tracking your reimbursement claim is now simple. Just follow the steps below and we will help in settling your claims faster.

• Notify us in advance of your upcoming claim. Go to your MediBuddy app or medibuddy.in and click the ‘Reimbursement’ tile. Fill in the details and click ‘Intimate’. You can also intimate us about your upcoming claim by logging on to the MediBuddy online portal.

• For submitting all your documents online for a reimbursement claim, login to the online portal and fill up the necessary details. Just take a picture of your documents and upload them onto the portal.

• Once you have uploaded your documents online, we will check if we have received all the necessary documents. We will intimate you in case of any missing/additional documents that may be required, so that you can upload them before you courier us all the required documents. This will help you eliminate sending couriers multiple times and stop worrying about unnecessary delays.

• Medi Assist begins the process of settling your claims once you upload the scanned copies of documents on MediBuddy. However, do not forget to send us the hard copy of all your bills and documents you have uploaded within 15 days from the date of discharge, as claims can be settled only upon receipt and validation of the hard copies.

So, what are you waiting for? Fast-track your claim reimbursement process today.

3 Simple Ways to Track Your Claim in Real-time

health insuranceTracking claims becomes extremely important if you plan to raise a claim for hospitalization. If you plan to opt or cashless hospitalization, pre-authorization is an important process that determines whether you qualify for cashless hospitalization. Depending on the sum assured for your treatment, you can be prepared with the amount you have to pay from your pocket including co-pay. On the other hand, if you plan to raise a reimbursement claim, you are bound to go through significant amount of paperwork before your claim gets settled. The claim settlement may also get delayed due to insufficient or incorrect records. Tracking your claim in all these scenarios becomes absolutely necessary so that you can plan your next step in advance.

But, making a claim and tracking it using traditional ways can be quite overwhelming as you may end up spending significant time trying to track it without obtaining a satisfactory response.

Now you have a smarter and efficient way of tracking your claim in real-time using the various options Medi Assist provides. Want to check the status of a reimbursement claim or want to know if your request for cashless hospitalization has been approved before hospitalization? We can help you do this in real-time and from anywhere.

How can you do this?

Medi Assist provides several options to help you keep track of your claim based on your Claim number, Medi Assist ID, email address or mobile number. Here are the options you can use.

– Use your MediBuddy app and click the ‘Claims’ tile. Enter your claim number and other details to track your claim. Alternately, you can use your mobile browser or go online to track your claim on medibuddy.in.

– You can also go to track.medibuddy.in and enter your details to search for your claim details.

– Opting for our SMS alerts is another good way of keeping track of your claim. Just SMS Claims [Claim Number] to +91 96631 49992 to obtain real-time status of your claim.

So, why lose sleep on inconvenient claim tracking processes? Self-help is empowering. Choose one of the aforementioned options and keep track of your claim in real-time.

Now Order Medicines to Your Doorstep

medicine

Falling sick and getting treated is an inescapable part of life. And with treatment comes prescription medicines, which can be bought from a medical store close to you. But there is no guarantee that the medicines prescribed to you are available at the medical store. There is also no guarantee that the alternate medicine provided by the pharmacist has the required composition prescribed to you. Moreover, why go to a medical store when it can come to you?

Now you can just order your prescription medicines from us and get it delivered to your doorstep in a simpler and faster way.

 

This is how you can do it

• Go to the MediBuddy online portal and click the ‘Medicines’ tile.

• Enter the patient details, delivery address where the medicines need to be delivered, and preferred time of delivery.

• Upload a copy of your valid prescription. Search for your prescribed medicines and place the order.

Medicines will be handed over to you upon validating the original prescription.

Why order from us?

While you can go and buy your prescription medicines from your closest medical store, here are the advantages of ordering your medicines from us.

• Assured availability of prescription and specialty drugs.

• Genuineness of the medicines you are buying from us.

• Attractive discounts on MRP on the medicines you are buying.

• Multiple payment options – Cash on delivery, credit card, Medi Assist prepaid card, or cashless if the prescription is covered under the insurance.

So, why wait in a queue at the medical store without the surety of getting the prescribed medicine? Order from us, and save your precious time and money.

3 Simple Steps to Maintain Your Personal Health Records Safely

How do you usually maintain your health records? We bet, you maintain a file of all the prescriptions, scans and tests, health screening reports, discharge summaries, and store it in a safe place. However, there are several problems associated with maintaining physical records. One problem is that you must be extremely organized in order to make sure that you keep the records in the same file in the same location every time you take it out. If not, they can never be found when you need them the most due to misplacement. Another problem is that paper can deteriorate over the years. You may even end up losing an important record and this may prove costly to you. Do not forget about the cumbersome process of carrying a physical record with you every time you travel.

Now, it is simpler to maintain all the health records in one place and never lose them again. Moreover, you can access your record anytime and from any place you want. How can you do it? Simply use the MediBuddy app or online portal.

How does it work?

• Go to your MediBuddy online portal, click on the ‘Records’ tile and sign into your account.

• Upload all the records onto the secured digital repository. In order to scan the documents, simply take a picture of them.

• Whenever you need to access any of these records, sign in or just enter your details to access them. You can view your documents on the MediBuddy app and download them from the online portal.

So, say good bye to the inconvenient ways of storing your health records. Switch to secure and efficient ways of storing them securely and accessing them anytime and from anywhere.