Can a hospital reject cashless treatments?

No, as per IRDAI, hospitals cannot deny cashless treatments to the insurance policy holders.

Which medical bills can be paid through this?

Any medical bills or treatments covered under the insured's healthcare insurance policy can be availed on a cashless basis.

Is there any documentation required?

Insured may need to carry valid ID proof and insurance policy documents for verification and cashless approval process.

Which hospitals are covered?

This initiative has tie-ups with numerous public and private hospitals across India to facilitate cashless transactions.

How long does the settlement take?

Insurer directly settles bills with network hospitals. Settlement timelines may vary between insurers and hospitals.

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Cashless Everywhere : Medical Bills For Health Insurance

Diya Vig

Author

Updated: 12-04-2025 at 12:30 PM

Payment of medical insurance bills upfront has always been a hassle and that too of great significance. Covering the cost upfront can be challenging. Especially in cases of emergency when treatment is nothing but avoidable. That is why, the General Insurance Council has come up with a new initiative called the ‘Cashless Everywhere’ and Cashless Health Insurance. This initiative helps the healthcare payment system by enabling seamless transactions. That too without the need for you to pay upfront. How does it work? By collaboration between insurance providers and healthcare facilities.

What Is A Cashless Everywhere Scheme?

Cashless Everywhere is a beautiful concept that permits you to avail cashless treatment at any hospital even if it is an emulator to the insurance company that you have subscribed to. With the help of this facility, you can avail of the fundless treatment, Cashless Medical Insurance and Cashless everywhere care health insurance at a hospital of your choice during emergencies without any harassment of hunting for a networked hospital.

What Is The Need For The Cashless Everywhere Initiative?

The following points showcase the need for the Cashless Everywhere Initiative:-

It gives the insured individual medical treatment without having to pay out of their pocket all at once. However medical insurance providers settle it with the healthcare facility on their own.
This initiative streamlines the payment process.
It reduces the administrative hassles and eliminates the need for reimbursement claims.
Moreover, it enhances accessibility to healthcare services, particularly for those facing financial constraints.

Objectives

The main objectives of the Cashless Everywhere scheme are as follows:-

Universal Access: Allow cashless treatment facilities in empanelled as well as non-empanelled hospitals.
Immediate Treatment: Minimise wait times for Americans to seek medical attention from doctors without going through a hospital first.
Simplified Process: The second internal control is to prevent large reimbursement claims and reduce payments on bills through negotiation with hospitals directly.
Reduced Fraud: Control the possibility of false claims when using the method of direct billing.
Time Efficiency: Very little paperwork is required for the actual processing of the claims.
Increase Health Insurance Usage: Help increase the uptake of insurance by embracing a cashless system when making claims.

Benefits

The following pointers showcase the important benefits offered by the Cashless Everywhere Initiative:-

No Hospital Restrictions: Cashless treatment is a facility available in all hospitals in India.
Quick Treatment Access: No need to approach a network hospital to avail cashless medical treatments without any delay.
No Reimbursement Hassle: Expenses are paid individually with the hospital as the contractor.
Reduced Fraud: Direct billing is the reduction of instances of fraud since it provides utmost transparency.
Time-Saving: Few compliance documents are often needed.
Enhanced Health Insurance Reach: Some of them come with a proposition of going for a fully cashless process for claims and will achieve easy insurance services across the country.

Access Cashless Treatment At Non-Network Hospitals

For both admitted and outpatients, self-referral is allowed in-network hospitals with options for cashless treatment during both elective and emergent hospitalizations.

Planned Treatment: You should notify your insurer 48 hours before the planned admission to the hospital.
Emergency Treatment: Contact the insurer within 48 hours of admission or before discharge.

How Does Cashless Everywhere Facility Work?

This facility operates under IRDAI’s guidelines to simplify cashless claims:

For Planned Treatments: Inform the insurer 48 hours before the admission of a member to a hospital.

For Emergency Treatments: The insured person should inform the insurer within 48 hours of admission to be eligible for cashless privileges.

How To Avail Cashless Everywhere?

Procedures to Get a Cashless Everywhere Facility are as follows:-

Customer’s Duty: For both planned and emergency hospitalizations, inform the insurer within the required timelines:

Planned Hospitalization: Please inform at least 48 hours in advance either through email – rgicl.cashlesseverywhere@relianceada.com or telephone no. 022-48903009.
Emergency Hospitalization: A minimum of 48 hours after admission to the hospital, make the notification.

Details to Provide:

Paternal first name and last initial of the patient and patient’s policy number/UHID
Doctor’s name And Qualification
Hospital name address and phone number
Initial examination results and a primary course of action

Hospital’s Duty: The hospital must send an admission intimation to Reliance General Insurance as per the following guidelines:

For Planned Hospitalization: Complete and send a signed Pre-Auth Form by the patient.
For Emergency Hospitalization: A Cashless Facility Request must be initiated within 48 hours from the date of admittance.

Documents to Provide:

Signed and Stamped Pre-Auth Form
Letter of Consent and MoU
Any defences that have the patient’s identification number
Medical records, treatment notes and cost estimate Familiegegevens; behandelnotities en een affecting van de kosten Health information; treatment notes, and estimating costs

How To File A Claim Under Cashless Everywhere?

Follow these steps to file a claim under Cashless Everywhere Initiative:

Intimate the Insurer: Report the insurer upon planned or emergent admission to a health facility.
ID Card Presentation: The patient’s insurance identification card should be produced during admission.
File Claim Request: Fill out an online cashless claim request form through email, mail or fax.
Submit Documents: Submit the required identification documents (know your customer and medical history).
Final Approval: The insurer approves documents for claims.
Bill Settlement: Once approved the insurer pays the bill as a whole to the concerned hospital.

Conclusion

Thus, the Cashless Everywhere initiative of the IRDAI is a customer-friendly approach and holds more flexibility than the earlier system. As it facilitates cashless treatment at any hospital, it does not allow the trouble of searching for network hospitals, the fuss of claims, and assists in emergency medical treatment.

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