The third-party payment system: why?

An increasing number of people take out a supplementary hospitalisation policy. In practice the cost of admission to hospital can obviously prove expensive. Moreover, the patient clearly has to pay more and more each year for the same treatment.

Due to the high price of hospitalisation it is also important for the insured to know whether or not his insurer will pay the hospital bill directly to the hospital. If so, he avoids having to advance substantial sums which he may not have at the time.

This is naturally an extremely important service to the insured, which is certainly appreciated for its worth.

The third-party payment in practice: four steps

1. The insured reports his admission to the insurer

From the moment that the insured person knows that he will be admitted to hospital he can notify his insurer.

This can be done in three different ways:

• via the Internet,
• by telephone
• via the AssurCard terminal in the hospital.

On the basis of the information received the insurer will decide whether it will advance the costs of this admission to the benefit of its insured. During this contact with his insurer, the customer immediately receives confirmation or rejection of his application.

2. The insured presents AssurCard at the hospital

The insurer receives information (card number, admission number and admission date) when the AssurCard is presented to the hospital reception desk. He then communicates his decision on advancing the costs to the hospital.

At this point in time the hospital knows who should be presented with the bill: the patient (traditional system) or the insurer (third-party payment system).

3. Electronic or paper bills?

When these two steps are completed, the hospital has the choice of sending invoices electronically or by paper.

• If paper billing is selected, the hospital forwards the patient bill, with the card number and admission number, to the patient’s insurer.

• If the hospital opts for electronic transmission this is arranged centrally via AssurCard.

The advantage of electronic transmission:

• the organisation of paperless claims settlement
• the insurer has an opportunity to collect enormous quantities of statistical data.

4. Payment of bills

The insurer then pays the entire bill to the hospital within thirty days. Uninsured expenses (telephone, excess, certain professional fee supplements, etc.) are settled between the insurer and the policyholder.

Advantages of the third-party payment system

• This is naturally a major service for the customer; no advance payment is asked at registration and the hospital bill is paid afterwards by the claimant’s insurer;
• Completely paperless claims settlement by working with electronic billing;
• Electronic billing also makes it possible to gather statistical material which the insurer can use during actuarial studies.