How do I file a cashless claim?

A hospitalization for yourself or your family member is a challenging time. Planning the treatment in advance as far as possible is the best way for you to go in for a medical procedure.

• You get an approximate of the cost of your treatment beforehand

• You have a fair idea of your out-of-pocket expenses

• You have one less thing to be worried about during the hospitalization.

1. How to start

 

To start a cashless claim, you would need to plan your treatment in a network hospital of your insurer. 

Click here to know how to find a network hospital.

2. Initiating a claim

In order to avail a cashless benefit, you should be visiting a network hospital of the insurer to undergo this treatment. All you would be required to do is intimate the hospital 2-3 days prior to the treatment and use your Plum health-ID as a valid document to get the cashless approval started.

 If you do not see your Health ID on your Plum app, reach out to us at [e-mail] or via the live chat option on our website.

In the event of an emergency, please reach out to us at 1800 30 911 911

3. What happens next?

 

The hospital help/insurance desk sends your documents to the insurer. You wait to hear back on the approval within a working day from the hospital help desk.

 

You can loop Plum in at this point (if you haven't already), and we'll be happy to share updates on your claim status along with guiding you throughout the process.

 

Please call us at 1800 30 911 911, 1-2 days before the hospitalization and our cashless team shall help you with a cashless claim.

 

4. Approving the pre-authorization

 

If all the documents submitted by the hospital are completed and correct, an approval from the insurer takes approximately 4 working hours to come through.

 

The approval letter from the insurer breaks down all the deductions. We recommend that you go through these in detail and seek any required clarifications with the help of the Plum Claims team.

5. Admission

 

More often than not, there are additional treatments required than the ones that you planned for. You will need to seek a final approval of the increased claim amount following the same steps as you did earlier - by reaching out to the hospital help/insurance desk and working with the Plum Claims team to get a status update.

6. Final settlement

 

The final settlement comes in from the insurer along with the discharge summary. Once again, we recommend you go through the fine-print of all deductions and seek all clarifications with the help of the Plum team. 

 

We're there to help you raise any disputes if the claim amounts are not justified.