Simplifying the Claims Process for Your Employees in Their Hour of Need

  • postauthorRaj
  • postdateJanuary 30, 2024
  • postreadtime4 min read
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When the mind has so many things to deal with, especially in the case of emergencies, panic and anxiety surrounds us with room for errors and shortfalls in claims and reimbursement of your healthcare plan. What if all of this chaos could be avoided? What if there were people to help you deal with the financial turmoil of treatment while you can concentrate of taking care of yourself or your loved one? 

The case of Palak 

  • Age: 48 years 
  • Gender: Female 

 On a cold winter night, Palak began sweating profusely and was on the verge of losing consciousness. Thankfully her son Sanjay had just finished work and returned home and rushed her to the hospital. Sanjay just wanted his mother, Palak to get the medical attention and treatment that his mother urgently needed. He was anxious not just about Palak’s treatment but also the financial liability that came with it. 

 Palak’s son remembers I was clueless about what to do. When a colleague reminded me that we have health benefits from work and my mother was included in my plan. But I was pleasantly surprised by the efficiency shown by the Good Doctors Team. 

 Just, tap… 

Sanjay had already downloaded the Onsurity app. He used to use to use it for buying medicines for his family at discounted prices from the app. He simply raised a claim request on the app, to the Onsurity concierge team: Good Doctors. The team picked up the case and assisted them with the coverage details and the cashless claim, step-by-step, clarifying the complete process.  

GDT assisted Sanjay with the coverage details of the group health insurance provided to members with the healthcare membership and the cashless step-by-step process was explained, including all the documentation and details that were needed. GDT acquired the hospital insurance desk contact details and coordinated with them to initiate the cashless process. In one hour, he received the confirmation for the initial approval from the insurance partner. 

 The unprecedented  

The hospitalization lasted for 5 days. Sanjay received calls regularly from GDT to understand the Palak’s health status and concerns. Eventually, patient was then advised to get discharged from the treating doctor. The final bill was generated by the hospital, and it amounted to a whopping Rs. 2,50,000. There was slight delay in response from the insurance partner. GDT followed up with the partner for the expedition of the claims process. 

 Sanjay and Palak’s GDT Experience 

 Palak’s mother was extremely relieved knowing that her son was able to manage the finances for the hospitalization without stress. She said, ‘The GDT was like family, constantly keeping in touch with my son and checking if everything is going well with my treatment.’ 

 The approval through Onsurity’s employee health benefits that included group health insurance came in but there were errors in the approval given by the insurance partner. Sanjay was on panic mode again, wondering what he would do now with a payable number for deductions. 

Good Doctors Team on full Scotland Yard mode… 

While Sanjay received the news, GDT was able to identify the discrepancy that led to the errors the final approval. GDT followed up and validated the request given by the insurance partner efficiently and went back to the insurer for the deduction reconsideration. Insurance partner quickly corrected the errors in the approval and provided with a revised approval letter to the member. 

More surety with Onsurity  

  • Claims Settlement with Onsurity assistance: 97% 
  • Wait Time: 2 hours 

“When you’re in hospital, the focus should be on care and not on getting your documents processed” – Onsurity’s Good Doctors Team 

Simplifying hospitalization formalities amid an emergency 

Onsurity’s Good Doctors Team simplifies complex claims reimbursement processes our employees by handholding them through the process. For employers, this means not having to deal with the paperwork and contacting the insurance providers on the behalf of the employees. It also means your employees can focus on getting the care needed and recover faster. 

We take on the complete responsibility of hospitalised employees on behalf of the employers. Our team handles everything, right from managing the claim documents to assist in getting the valid claim processed and checking up on their recovery.  

How to File Claims Via the Onsurity App? 

  • Open the app on your phone 
  • Tap on Health Insurance  
  • Tap on Claim Now (below your e-health card) 
  • Check the box next to “I understand Onsurity’s role and would like to proceed” 
  • Tap on Proceed 
  • Tap on Raise a Request 

Testimonial from Palak’s family 

I am extremely grateful to Onsurity for taking care of all the problems. They explained the end-to-end process thoroughly and helped us overcome all challenges without any delay. Hats off to Onsurity and Good Doctors Team supporting us during hospitalization. 

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