Outlook Money
Pre-approval indicates that an insurer may cover treatment expenses within the limits of a health insurance policy, giving patients early clarity on expected medical costs.
Pre-approval helps patients understand how their hospital bills will be settled, thereby reducing financial uncertainty and easing stress during treatment.
Pre-approval, also known as cashless authorisation, indicates that planned or emergency treatment may be paid for in accordance with policy terms and coverage limits.
Pre-approval clarifies whether the insurer will pay the hospital directly or if the insured must pay first and later claim for reimbursement.
Pre-approval confirms that the insured was eligible for claim consideration at the time of hospital admission, but it does not guarantee final claim approval.
Pre-approval plays an important role in surgical or complex treatments, where hospital stays may be longer and treatment costs can increase.
Hospitals are required to seek pre-approval before planned admissions or within 24 hours of emergency hospitalisation, based on initial treatment cost estimates.
Delays or denials can cause financial and emotional stress, often due to policy exclusions, waiting period clauses, or incomplete documentation.