Most progressive organisations offer group healthcare insurance policies to their employees as a service benefit to provide monetary support at the time of medical emergencies. The idea is ensure that employees have access to the best healthcare services and infrastructure and do not have to access their savings due to unforeseen events. Employees can use the cashless or the reimbursement claim facility to cover the hospitalisations costs. Therefore ot is important that your insurance service provider has a proven track record in ensuring that claims aren’t rejected on invalid grounds. If your employees have to painstakingly follow up on their claims, is there a point in offering such medical coverage?
Usually, employees have had to reach out to their employer or the HR SPOC of their company to access the details of filing for claims under their group health plans. Now though, with the advent of technology the process to file for claims has become much simpler. Employees now get a dedicated portal to view their benefits, add family members and apply for claims. The HR or the policy administrator now focus on more important tasks and do not have to become mediators. In addition, we at PlanCover also provide an organisational portal which allows the policy administrator to get an overview of the progress of claims filed by their employees or the total number of members covered.
The role of technology in the claim structure
Why do you think the process has become simple? Technological advancement. All leading insurance providers have e-claim options to make the claims process stress-free. In fact, the efficiency to process these claims has also increased reducing the time it takes to payout the claimed amount. Online portals and one-click claims have significantly accelerated the process and improved the method of getting monetary support during medical concerns.
Easy-to-understand claim process
Even a few years back, people were reluctant about getting insurance. In fact, the employer-sponsored group healthcare policy was also not a lucrative service benefit to many employees. Do you know the reason? The inefficiency of third party administrators and insurance providers to settle a claim was the primary reason! Traditionally the only way to file for claims was to fill out an extensive form and submit all the original documents to the insurance provider. Nowadays, even though sending original documents is mandatory, you can start the process of filing even if you upload the soft copies of these documents. This allows for a reduced time gap between your employees filing for a claim and them getting a payout on it.
We understand that you might come across some technical jargon when you file for an insurance claim. We have detailed videos explaining all the processes in detail. You can even find a detailed video to help you fill up the claim form along with a checklist of documents to be submitted.
A hassle-free choice for all
Electronic claiming is not at all difficult. The techniques of submitting cash receipts of the hospital and medical expenditure is very systematic. Fill up the forms correctly and submit the necessary documents. As the process has gone online, you can find options to file the claim directly to the insurance company. The official website of all the leading insurance companies provides you with a simple online interface to submit the claims.
You can opt for cashless hospitalization at one of the hospitals which fall under the network of the insurance provider. However, if you undergo treatment outside the network of the registered cashless hospital names, you have to file a claim for a reimbursement. But worry not! As you can sit and relax while the claim gets accepted and processed. Eliminate the worries of running to the TPA office or calling your boss to guide you with the correct steps.
- A note for the insurance holders – Employees with group healthcare coverage may not always be well aware of the technical terms and requirements of the claim process. Thus, they get puzzled when they encounter a medical emergency and sudden hospitalization. Avoid such issues by connecting to a hospital that provides cashless treatment. However, if you cannot find the chance to get admitted to a hospital under the cashless network, do not panic. You can reach out to the customer care number of the insurance company or contact your intermediary directly. Asking your employer for help may not be wise as they have other things to manage and may not know the exact steps. So, take a sensible call and connect to the professionals who have proven experience in tackling payment of claims.
Stay prepared and clear your doubts.
Staying prepared about the claiming process can save you at the last moment. First, list the essential documents that you have to submit for filing the claim. Your insurance broker can help you with the information. You can also review the insurance company’s official website to note the requirements. Keep these things ready and scanned so you can upload them into the online claiming portal when needed.
Also, connect to the hospital and collect all the necessary receipts and documents you will put up for getting a reimbursement. Staying prepared is the best option for you as an insurance holder because you need not hurry at the last moment. Go through the website and read the steps for a systematic e-claim process to stay well-informed.
- A note for the employer – How would you know if your insurance provider supports e-claim or offers a hassle-free online reimbursement process? Your insurance intermediary can help you understand the pros and cons of buying the insurance from a specific insurer. They can help you make a decision backed with data on current trends for each insurers claim payment ratios and reimbursement support history, you can make a informed choice to buy the company’s insurance policy. The new-age digital portals for claim submission and online tools are the best solution for ensuring a hassle-free claiming experience. Thus, while you purchase your group health policy from a broker or directly from a company, enquire about such offerings. Do not purchase if the insurance provider does not offer a hassle-free and convenient e-claim settlement option. This way, you can help reduce your employees’ stress as they do not have to get confused with the complex steps of physical claim submission.
PlanCover – Dedicated support for every insurance requirement
At PlanCover we have created an in house portal for managing insurance policies. The portal provides dedicated logins to all your employees to view benefits, add their family members and manage their claims. The claims process gets extremely simplified as we take proactive action in making sure that claims filed by our clients and their employees are processed within stipulated timelines and are paid in full. All our members have access to repository of blogs, how-to’s and explainer videos that come in handy. Your employees will now have a direct line with PlanCover to help them resolve their queries related to insurance. As an HR or an employee you will not have to run around being the mediator between your employees and us.