We often try to avoid challenging things in our life to get easier ones. When discussing health insurance, we try to prevent the technical guidelines of the plan we are purchasing but follow and read the terms and conditions of your health coverage policy. However, every health insurance policy has another document called Policy Wording that is entirely avoided by the agents and buyers. This is needed because the document requires technical association. It’s because translating the technical meaning of the document can be a difficult task. But how would you imagine when your health claim has been rejected due to a simple technical mistake done from your side?

 

Day Care Treatment Vs OPD Treatment

 

1.   Day Care Treatments

 

To file a health insurance claim, a person has to admit to the hospital for a minimum of twenty-four hours. However, various treatments don’t take a long time because of several technological developments. A few decades ago, a patient moving under cataract operation should be admitted to the hospital for a few days. But, technological development has modified the surgery to the extent that a patient can be discharged from the hospital on a similar day.

 

Day Care procedures include such treatments and are covered by various health insurance plans if they come under the list of covered treatments available in the policy wording.

 

2.   OPD Treatments

 

The Outpatient Department or OPD treatments demonstrate those cases when the cure and diagnosis of the pain are practised on the advice of a medical practitioner or doctor at the hospital or their private clinics.

It might be observed that Day Care and OPD Treatments are equal in nature because they include a low treatment time. However, there is a fine difference between these two treatments.

 

Instead of the apparent equalities between Day Care and OPD treatments, the basic difference stays at the level of hospitalization. In a Day Care treatment, you should be hospitalized for the treatments even if takes a low time. Only then you are allowed to claim your medical expenses from the health insurance company. OPD treatments don’t require hospitalization. You should easily walk into a hospital or clinic and achieve the treatment being done without being admitted for it. Even in the case of Day Care treatments, the patient is treated on an outpatient basis without being hospitalized and the claim doesn’t come under Day Care procedure, for example, a root canal treatment is similar to the procedure. You can receive a root canal treatment in a hospital or clinic without being hospitalized. Thus, the treatment is categorized under the OPD category. On the other hand, dental surgery is performed in the event of an accident that may result in a Day Care treatment.

 

Day Care and OPD Treatments Claim Settlement

 

Claiming for Day Care procedures is equal to claiming regular hospitalization. Most Day Care procedures are performed regularly and you can use the cashless system to pay for your treatment in a network hospital. Inform the health insurance provider well in advance by submitting all the required documents. If the procedure is performed in a non-network hospital, you can claim a refund by submitting documents within seven days depending upon the terms and conditions of your insurer. The OPD covers various works like protection-based health plans. OPD expenses can be claimed after providing the necessary documents. However, OPD reimbursements are based upon the sub-limits mentioned in the policy wordings. However, you have to follow and clearly understand policy wording through some definitions and differences between words to words for making a valid claim.    

 

Final Verdict

 

Now, a health insurance policy can be purchased online and you can ask for medical settlements online easily. You will get reimbursement at your attached account or given account within 7 days once the claim gets settled for non-network hospitals. Before purchasing, understand the powered or technical words mentioned in a health policy because these words can guide you while asking for online or offline medical claim settlements from a health insurance company. You should also understand the basic difference between Day Care and OPD treatments through this write-up.