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Claims Support Services
Navigating insurance claims can be overwhelming. We provide hands-on support to help you get the benefits you are entitled to, without the stress.
Cashless Admission Support
We help you get cashless approval quickly, coordinate with hospitals and insurers, and ensure a smooth admission process.
Documentation Assistance
We review your documents, identify missing paperwork, and guide you on what is needed for a successful claim.
Insurer Coordination
We follow up with insurers and TPAs on your behalf, saving you time and ensuring your claim moves forward.
Rejected Claim Appeals
If your claim was denied unfairly, we help you understand why and assist with the appeal process to fight for your settlement.
Understanding Insurance Claims
Filing a claim can feel overwhelming, especially during a medical emergency. Understanding the process helps you get the benefits you deserve.
What is an Insurance Claim?
An insurance claim is a formal request you make to your insurance company asking them to pay for expenses covered under your policy. For health insurance, this typically means requesting payment for hospitalization costs, medical procedures, or treatments.
The claim process involves submitting required documents, getting approval from the insurer, and receiving payment either directly to the hospital (cashless) or as reimbursement to you after you have paid the bills.
Why Do Claims Get Rejected?
Claims are often rejected due to incomplete documentation, non-disclosure of pre-existing conditions, treatment at non-network hospitals, policy exclusions, or exceeding sub-limits. Many rejections happen because policyholders are unaware of their policy terms.
Understanding your policy coverage, maintaining proper documentation, and following the correct claim procedure significantly increases your chances of a successful claim settlement.
Types of Health Insurance Claims
Cashless Claims
Get treated at a network hospital without paying upfront. The insurer settles the bill directly with the hospital. Requires pre-authorization and is the most convenient option during emergencies.
Reimbursement Claims
Pay for treatment yourself and submit bills to the insurer for reimbursement. Useful when treated at non-network hospitals or when cashless facility is not available. Requires all original documents.
Pre-Authorization
For planned hospitalizations, you need prior approval from the insurer. Submit the pre-authorization form with treatment details 3-4 days before admission to ensure smooth cashless treatment.
How Thodu Helps with Claims
Filing an insurance claim can be stressful, especially during a medical emergency. Thodu provides end-to-end claims support, from helping you understand what documents are needed to coordinating with hospitals and insurers on your behalf.
We assist with cashless authorization, documentation review, follow-ups with the TPA or insurer, and even help you appeal if your claim is rejected. Our goal is to ensure you receive the benefits you are entitled to without the hassle of navigating the complex claims process alone.
Helpful Articles
Explore our helpful articles to gain expert insurance tips, practical guidance, and insights that protect your future effectively.
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Speak with one of our experienced insurance advisors today and find the coverage that's right for you. Your peace of mind is our priority.
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