Posted by What is a day care procedure?
A daycare procedure is a medical operation or surgery in medical research, that may now be finished in less than 24 hours. The term “daycare procedure” is used in the context of health insurance. Only if a daycare procedure is considered medically necessary and has been prescribed in writing by a doctor it will be reimbursed by health insurance.
Here are a few frequent medical procedures that frequently fall under the purview of the daycare procedure:
- Appendectomy
- Piles / Fistula
- Angiography
- Dialysis
- Cataract
- Chemotherapy
- Colonoscopy
- Sinusitis
- Eye surgery
- Hydrocele
- Lithotripsy
- Liver aspiration
- Prostate
- Radiotherapy
- Sclerotherapy
What Is The Difference Between Daycare Procedures And Opd
It is crucial to remember that daycare policies do not apply to treatments received in the OPD (Out-patient Department). Hospitalization cannot be referred to as a daycare process unless you are admitted to the medical facility.
It will be regarded as daycare if you are checked into a hospital room and have surgery in an operating room while unconscious. Even if you receive treatment under local anesthetic in the doctor’s office, a nearby medical facility, or the emergency room, it is still regarded as an OPD charge.
A few examples of OPD treatments include placing a plaster cast at the OPD location or managing a wound. While surgery performed in an operating room followed by the application of a plaster cast will be regarded as a daycare procedure.
The Claim Process For Daycare Procedures
- Since the daycare procedure cover is a built-in policy element, the filing process for daycare claims is comparable to that of a conventional health insurance claim. The insured may use the insurance company’s network hospitals’ reimbursement or cashless hospitalization services.
- Pre- and post-hospitalization benefits are still covered under the same clause.
- Additionally covered by these policies are medical expenses, dental work, diagnostic procedures, and doctor’s visits. There may, however, be some exceptions.
- The policy document’s sub-limits are likewise applicable to these costs. It is advisable to thoroughly read the policy document because different policies may have different coverage options.
Advantages Of Day Care Procedure And Treatments In Health Insurance
Beyond the operation or surgery, daycare procedures are also performed. The costs of daycare treatments frequently include those for diagnostics, prescriptions, hospital admission, vitals, and injections, as well as post-hospitalization costs.
Therefore, when you add all of these costs up, the overall cost of a particular treatment can be rather expensive. This is where your health insurance comes in since it provides financial support for your treatment.
How To Choose A Daycare Health Insurance Plan
To attract clients, the majority of health insurance firms highlight the “number” of daycare treatments covered by their policy. Therefore, inexperienced health insurance purchasers make the mistake of selecting a health insurance plan with a high number of daycare procedures.
However, there are other factors to take into account before investing in addition to the number of daycare operations included in medical insurance policies. When choosing a health insurance plan, factors like co-pay, age, sub-limit restrictions, cashless facilities, and others are crucial.
Quality Vs Quantity
It is best to think of the treatments that are covered by daycare procedures as a whole. For instance, considering 20–30 bigger categories like urology, oncology, etc. is a more useful, advantageous, and inclusive method than looking at 200+ names of numerous separate surgeries, as these broad categories cover a large number of treatments.
Additionally, it is advisable to choose the more inclusive categories that even a beginner may grasp for all intents and purposes. Additionally, a firm that provides a detailed list of specific operations may decline to cover new therapies that emerge in the future as a result of advancements in medical science.
It is smarter to choose the plan with a broader classification or, better yet, with all-inclusive daycare procedures when contrasting different plans with comparable features and benefits.
Category Cover
Daycare treatments are typically listed by public sector insurers in broad categories. The benefit is that one can ask third-party administrators to add a certain type of daycare procedure if it was not included at the time of policy purchase before starting treatment.
Process Of Filling Daycare Claims In Health Insurance
Since daycare procedure coverage is an intrinsic part of the policy, the method for filing daycare claims is comparable to that of a standard health insurance policy. For planned procedures, the cashless option is available however, some businesses require advance notice.
In other instances, after receiving the necessary paperwork, insurers pay out. The provisions for pre- and post-hospitalization benefits are also the same; the insurance provider pays the policyholder’s hospitalization costs.