What is a Reimbursement Claim? A reimbursement claim is an alternative to the Cashless medical insurance claim, where the claimant pays for the medical expenses out of their pocket and later applies for the insurance. When is an out-of-pocket claim applicable for you: Reimbursement claim vs Cashless claim? 1. Required Treatment unavailable in a Network Hospital – Cashless claims are granted only for treatments availed in network hospitals. So if the individual wishes to get their treatment of choice outside the network, they can use this option. 2. Emergency Medical Treatment – In situations of urgent need of medical care like hospitalization, or long-term treatments like diabetes, individuals often choose to pay themselves on the spot and later file the claim for their hospital expenses. This way, they don't have to wait for claim approval to get the much-needed treatment. 3. Cashless Claim Approval taking too much time – Due to various reasons, the cashless claim can take more time to get approved. It is usually due to unforeseen technical or administrative hurdles by the hospital or the insurance provider. 4. Partial Approval of medical expenses under Cashless claim – In many cases, the claimant is only able to get part of their medical expenses insured under the Cashless scheme. In those situations, they can get the rest of the expenses insured through reimbursement. 5. In-Network Hospital does not offer Cashless Service – Sometimes, network hospitals do not provide Cashless insurance services for the desired insurance provider or insurance policy. In which case, the only viable option becomes reimbursement. How to apply for reimbursement of medical expenses with SimpliInsure? Step 1: Inform your Insurance Provider Your insurer or any Third Party Administrator (TPA) needs to be informed about planned hospitalizations and treatments in advance, or at the earliest possible time for unplanned emergencies. Step 2: Pay your Hospital or Treatment Bills The medical expenses need to be settled directly with the healthcare provider, and all the medical receipts and invoices are to be saved for claiming the insurance later. Step 3: Collect all Medical Documents related to the Treatment To help claim the reimbursement later, make sure that you preserve the following documents: ● Original bills and receipts, ● Discharge summary, ● Doctor’s prescriptions,