Star Health & Allied Health Insurance Network Hospitals

A cashless network hospital is one that is in partnership with the insurance company so as to offer cashless medical facilities to policyholders. When the insured avails the cashless hospitalisation facility he/she is not required to pay ahead for the medical expenses. These costs are deducted from the annual sum assured of the policyholder's health insurance. The settlement takes place directly between the network hospital and the insurance company.

It should be noted that cashless hospitalisation services are offered only if the policy includes coverage for the treatment that the insured seeks. Also the policyholder is required to produce proof of insurance, either through an ID card issued by the insurer or by furnishing the policy document. As mentioned above, STAR Health Insurance has more than 7950 network hospitals across the country that provide cashless hospitalisation facility to policyholders.

What are the types of claims that can be done at Star Health Insurance network hospitals?

The following types of claims can be executed at Star Health Insurance network hospitals:

1. Cashless Claims - In case the insured seeks medical attention at any of the hospitals in the insurance company's network, he/she will not be required to pay for the expenses. Instead the insurer settles the bills directly with the network hospital, ensuring a hassle-free payment process.
2. Reimbursement Claims - If the insured seeks medical attention at any hospital, he/she will be required to pay for the expenses. Following discharge, the insured can raise a claim under the policy for the reimbursement of medical bills. Star Health Insurance reviews the claim, and if found valid, settles the bills in the shortest possible time.

How do you file claims at Star Health Insurance network hospitals?

The claim process for cashless hospitalisation is as follows:

1. The insured approaches any of the network hospitals and produces the Star Health ID card at the hospital insurance desk.
2. The hospital contacts the insurer with the patient information and medical details through the pre-authorisation form.
3. The insurer reviews the request and informs the hospital of their decision.
4. The insurance company settles the claim directly with the hospital, as per the policy terms and conditions.

The claim process for reimbursement hospitalisation is as follows:

1. The facility for reimbursement claims is available at both network hospitals and non-network hospitals. The insurance company should be intimated within 24 hours after hospitalisation.
2. The insured avails the treatment, pays the bills, and raises a claim for the settlement of expenses.
3. The insurer reviews the claim documents and releases the payment accordingly.
4. It should be noted that the claim documents should be sent to the insurer within 30 days from the discharge date.

Procedures offered/covered in Star Health Insurance network hospitals across India

1. The health insurance policies from Star Health Insurance usually provide hospitalisation cover if the insured is hospitalised for more than 24 hours. This includes the cost of room and the nursing charges.
2. The fees for surgeons, general medical practitioners, consultants, anesthetists, and specialists are all covered under most of the plans. Operation theatre charges and the cost of medicines are included as well.
3. The policies also usually cover ambulance charges.
4. Pre-hospitalisation expenses up to 30 days before admission and post-hospitalisation expenses up to 60 days after discharge are usually covered in the plans offered by the insurer.
5. Some policies also cover ophthalmic or dental treatments on an outpatient basis.

However, the coverage varies between different policies and the specifics will be listed in the terms and conditions of the policy document.

Exclusions under Star Health Insurance network hospital services

The standard exclusions to the Star Health Insurance policies are as follows:

1. Treatments under alternative medical streams, i.e., non-allopathic medicine, will be excluded.
2. Cosmetic or aesthetic treatments are usually not covered under the Star Health Insurance policies.
3. Treatment for issues due to solvent or alcohol abuse and usage of narcotics will not be covered.
4. Bodily injuries arising out of participation in any dangerous hobby or pursuit will not be covered.
5. Treatment for complications arising from attempted suicide or self-inflicted injury will not be covered.
6. If the insured commits any anti-social activity with criminal intent, then he/she will not be covered for any bodily injuries arising out of that.