Planned or emergency admission — here's the exact cashless process, what to carry, what you pay at discharge, and what to do if cashless is denied.
How to file a cashless claim, step by step
A cashless claim lets a network hospital settle the covered amount directly with your insurer, so you pay only the non-covered part. The process is straightforward once you know the steps, and whether your admission is planned or an emergency.
Planned hospitalisation
- Confirm the hospital is in-network. Cashless works only at network hospitals. Check the current list.
- Intimate the insurer in advance. Give notice a few days before admission.
- Submit pre-authorisation. The hospital insurance desk sends your diagnosis and cost estimate to the insurer or TPA using your health card.
- Get approval. The insurer approves an admissible amount, sometimes in stages.
- At discharge, the insurer settles the approved amount with the hospital; you pay co-pay, deductible and non-payable items.
Emergency hospitalisation
- Get admitted and stabilised first.
- Intimate the insurer within the policy emergency window (a family member can do this).
- The hospital raises pre-authorisation once you are stable.
- Approval and settlement follow the same path as planned admission.
Keep it smooth
- Carry your health card or policy number and a photo ID.
- Understand that pre-authorisation is an estimate; the final amount is confirmed at discharge.
- Keep copies of everything. If cashless is partly denied, you can claim the balance by reimbursement.
Frequently asked questions
How soon must I inform the insurer for a planned admission?
Usually a few days in advance; check your policy stated notice period. For emergencies, intimate within the short window the policy specifies, even after admission.
What do I pay at discharge in a cashless claim?
Your co-pay, any deductible, non-payable consumables, and anything above your sum insured or sub-limits. The insurer settles the rest directly with the hospital.
What if cashless is denied at the hospital?
It is usually a documentation or eligibility issue, not a final rejection. Pay the bill and file a reimbursement claim with the same documents.
Can I use cashless at any hospital?
No, only at hospitals in your insurer network. For non-network hospitals you pay first and claim reimbursement.