Network Hospital List: Why it is Important While Choosing a Group Health Insurance Policy

What is Network Hospital?

A network hospital is a healthcare facility that has partnered with an insurance provider to offer cashless medical treatment. This means every insurer has partnered with hospitals or medical facilities in your state, city in a form of a contract. This means that instead of paying out of pocket and later filing for reimbursement, your insurer directly settles the bill with the hospital, as per the terms of your policy.

What is a Non-Network Hospital?

Non-Network Hospitals are nothing but the ones that are not listed in the network hospital list of the insurer. This does not mean that the treatment cannot be done in these hospitals. But, it comes with a catch. The cashless facility cannot be availed in such cases. Not all hospitals can be part of the network hospital list, but, most of the top care centres.

How Do Network Hospitals Work?

To understand how a network hospital functions, let’s take an example.

Amit has health insurance with XYZ Insurance, which has a tie-up with ABC Hospital. When he requires surgery, he chooses ABC Hospital for treatment. At the hospital, he presents his insurance card, and the hospital requests pre-authorization from XYZ Insurance. Once the approval is received, Amit undergoes treatment without making any upfront payments, except for any exclusions in the policy. Since ABC Hospital was part of the network hospital list provided by Amit's employer, the insurance company settles the bill with the hospital, ensuring a hassle-free experience for Amit.

This process eliminates financial stress and makes hospitalization seamless.

Benefits of Choosing a Network Hospital

Opting for a network hospital offers multiple advantages, including:

• Cashless Treatment – No need to arrange large sums of money during emergencies.
• Lower Medical Costs – Insurers negotiate pre-fixed rates, making healthcare more affordable.
• Hassle-Free Claims – Avoid lengthy paperwork and reimbursement delays.
• Quality Healthcare – Insurance companies conduct thorough evaluations before adding hospitals to their network.

How to Find a Network Hospital Near You?

Finding a cashless hospital near you is simple. Here’s how:

• Check Your Insurer’s Website – Most insurance providers maintain an updated list of network hospitals online.
• Use Medi Assist’s Network Search – This platform helps you find network hospitals based on location.
• Try Mobile Apps – Apps like MediBuddy allow real-time searches and even enable pre-authorization requests.

There are 363 Go Digit network hospitals in Bengaluru, providing extensive coverage for policyholders seeking cashless treatment.

Insurer-wise & TPA-wise Network Hospital Lists: Your Guide to Seamless Healthcare

Navigating health insurance can feel overwhelming, especially when you need cashless hospitalization at a network hospital. Finding the right network hospital list for your insurer or Third-Party Administrator (TPA) can save you time, effort, and unexpected expenses. This guide will help you quickly locate network hospitals so you can access medical care without financial stress.

Insurer-wise Network Hospital Lists

Each insurer partners with hospitals across India to provide cashless treatment. Here’s how you can find network hospitals for major insurers:

TPA-wise Network Hospital Lists

Third-Party Administrators (TPAs) act as intermediaries between insurers and hospitals, ensuring smooth claim settlements. Many TPAs manage their own network hospital search portals for policyholders.

Apollo Hospitals: A Leading Example of Network Partnerships

Apollo Hospitals, a pioneer in India’s healthcare industry, has set benchmarks for excellence in medical services. With an extensive network of hospitals, pharmacies, and diagnostic centers across the country, Apollo is more than just a healthcare provider—it is a leader in forging strategic partnerships with insurers and Third-Party Administrators (TPAs) to streamline cashless treatments. Let’s explore how Apollo’s collaborations are transforming health insurance and patient care.

Apollo’s Network Partnerships with Insurers and TPAs

Apollo Hospitals collaborates with multiple insurers and TPAs to facilitate cashless hospitalization, ensuring that policyholders receive high-quality medical care without worrying about upfront payments.

Insurance Company Partnerships

Apollo has partnered with some of India’s top insurance providers, including:

• New India Assurance
• National Insurance
• United India Insurance
• Oriental Insurance
• HDFC ERGO (formerly Apollo Munich Health Insurance)

TPA Collaborations

To streamline claim management, Apollo works with leading TPAs such as:

• Medi Assist India TPA Pvt. Ltd.
• Bajaj Allianz GIC Ltd.
• E-Meditek TPA Services Ltd.
• Vidal Health TPA Pvt. Ltd.
• Health India TPA

Innovative Collaborations: The Case of ClaimBuddy

In 2024, Apollo Hospitals partnered with ClaimBuddy, a health insurance claim processing startup, to revolutionize claim approvals. This collaboration leverages ClaimBuddy’s advanced technology to:

• Expedite claim processing.
• Reduce administrative overheads.
• Enhance the overall efficiency of Apollo’s insurance desk operations.

Srinivas, Senior Manager of Revenue Assurance at Apollo Hospitals, highlighted the impact of this partnership:

"ClaimBuddy’s innovative solutions empower us to accelerate claim approvals, reduce paperwork, and improve the efficiency of our insurance desk operations."

This initiative underscores Apollo’s commitment to providing a seamless experience for patients navigating health insurance claims.

How Apollo Facilitates Cashless Hospitalization

Apollo Hospitals has streamlined the process for cashless treatment through its dedicated Insurance Cell. Here’s how it works:

Planned Hospitalization

• Consult your doctor and schedule your admission.
• Submit a pre-authorization request at least 4–5 days before admission for estimated hospital expenses.
• The Insurance Cell coordinates with your insurer or TPA for approval.

Emergency Hospitalization

• The Insurance Cell fast-tracks pre-authorization requests.
• Approvals are typically received within three hours during working days.
• If approval is delayed, patients can pay a deposit and get reimbursed later.

Why Apollo Stands Out in Network Partnerships

• Wide Reach: With 71 hospitals, 3,400 pharmacies, and 150 diagnostic centers across India, Apollo ensures easy access to quality healthcare.
• Technological Innovation: Collaborations like the one with ClaimBuddy highlight Apollo’s commitment to leveraging technology for a smoother patient experience.
• Omnichannel Approach: Through its digital platform, Apollo Healthco Limited, Apollo integrates outpatient services, insurance claims, and payment innovations under one umbrella.

Key Benefits for Patients

• Cashless Treatment – No upfront payments, as insurers settle bills directly with Apollo.
• Hassle-Free Claims – The Insurance Cell handles all documentation and insurer/TPA coordination.
• Comprehensive Coverage – From planned surgeries to emergency care, Apollo’s partnerships ensure seamless medical access.

Apollo Hospitals continues to lead the way in network hospital partnerships, making high-quality healthcare accessible, affordable, and hassle-free for policyholders across India.

How to Use a Network Hospital: A Step-by-Step Guide

Using a network hospital for cashless treatment is a hassle-free way to access medical care without worrying about upfront payments. Here’s a step-by-step guide to making the most of this benefit.

Step 1: Show Your Health Insurance Card or e-Policy

Upon arrival at the network hospital, present your health insurance card or e-policy at the insurance desk. This step notifies the hospital that your treatment is covered under a cashless facility. Ensure you also provide a valid ID proof for verification.

Step 2: Hospital Coordinates with Insurer/TPA for Approval

After submitting your insurance details, the hospital will coordinate with your insurer or Third-Party Administrator (TPA) to obtain pre-authorization for your treatment. This process includes:

• Filling out a pre-authorization form with details about your policy.
• Providing medical information and estimated treatment costs.
• Awaiting approval from your insurer before proceeding with treatment.

Step 3: Get Treated Without Upfront Payment

Once your pre-authorization is approved, you can proceed with treatment without making any upfront payments. The insurer settles the bill directly with the hospital, ensuring a seamless experience. However, expenses not covered under your policy (such as consumables or non-medical items) may need to be paid out of pocket.

Additional Tips for a Smooth Experience

• Verify Coverage: Before hospitalization, check your policy details, including sub-limits and exclusions, to avoid surprises.
• Notify Your Insurer: For planned hospitalizations, inform your insurer at least 72 hours in advance. In emergencies, notify them within 24 hours.
• Keep Records: Maintain documentation of all communications with your insurer in case of any disputes or delays.

How HR Teams Can Promote Cashless Benefits

• Workshops and Webinars – Conduct regular sessions to educate employees on cashless hospitalization and network hospital lists.
• Digital Resources – Provide easy access to insurer websites, TPA portals, and mobile apps for seamless network hospital searches.
• Employee Handbook Updates – Include clear guidelines on how to use cashless benefits, ensuring employees have the information at their fingertips.

By empowering employees with the right knowledge, HR teams can foster a workplace where health and financial security go hand in hand. This not only enhances employee well-being but also strengthens the organization's overall success.

Start educating your team today and witness the transformation in employee satisfaction and workplace productivity!

Conclusion: Empowering Employees with Cashless Benefits

HR teams play a crucial role in educating employees about cashless healthcare benefits, ensuring they maximize their health insurance coverage. When employees understand how to access network hospitals, they can avoid upfront medical expenses, reducing financial stress during emergencies. This, in turn, leads to higher retention rates, as comprehensive health benefits foster a sense of security and loyalty. Additionally, timely medical care without financial burdens enhances productivity by allowing employees to focus on work without health-related worries.