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Home>Health Insurance>

What is the importance of Discharge Summary in Health Insurance?

What is the importance of Discharge Summary in Health Insurance?

A discharge summary is a detailed summary of a patient's hospital stay. It details all the treatment procedures, medications, and post-discharge care instructions. While it may appear to be just a medical note a patient receives during discharge, it plays a significant role that extends beyond the hospital. For individuals seeking to reimburse their expenses under a healthcare policy, this document plays a crucial role in the claims process. Understanding the importance of the discharge summary for insurance claims can help file a successful claim registration.

Quick Links

  • What is a Discharge Summary
  • Importance of Discharge Summary
  • Health Insurance Claim Process & Role of Discharge Summary
  • How Discharge Summaries Impact Claims
  • Common Mistakes in Discharge Summaries
  • How to Ensure Your Discharge Summary Is Insurance-Ready
  • What to Check Before Leaving the Hospital?
  • Conclusion
  • FAQs

What is a Discharge Summary in Health Insurance?

Put simply, a discharge summary includes pointers on what happened to the patient in the hospital. It also mentions all the instructions to be followed post-discharge to reduce the chances of rehospitalisation. Here are some details mentioned in the discharge summary.

  • Date and time of admission and discharge
  • Symptoms and complaints during hospitalisation
  • Diagnosis details
  • Medication throughout the hospital stay
  • Summary of medical procedures performed (if any)
  • Post-discharge care instructions

Importance of Discharge Summary in Health Insurance

The discharge summary of the hospital is one of the primary documents insurers will look for before approving a claim. It helps them understand the following.

  • The reason for hospitalisation
  • Duration of stay
  • Medical procedures done during the stay
  • Equipment and medication required for treatment

Health Insurance Claim Process & Role of Discharge Summary

The purpose of a discharge summary is to enable the insurer to ensure that the policyholder is hospitalised. It also helps determine the length of the hospital stay and the procedures performed during treatment. Here's how the insurance claim process works.

  • Verifying and settling hospital bills
  • Gathering all necessary documents, including:
       -Discharge summary
       -Medical receipts
       -Pharmacy bills
       -Doctor's prescription
  • Register for the claim and submit additional documents, such as the claim form, ID cards, health card, cancelled cheque, FIR (in case of accidents), and hospital documents.
  • Wait for approval
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How Discharge Summaries Impact Claims

The clarity and accuracy of a hospital discharge summary are essential for a successful claims process. Without this clarity, your claim can be delayed or rejected; here's how:

Rejection

The insurer might reject your claim without a clear and accurate discharge summary.

Delayed payments

Without clarification, the insurer will put your claim on hold.

Claim amount

A discharge summary gives a gist of the total expenses. If there is a difference between the discharge summary and other documents, the insurance company will reduce the approved claim amount.

Common Mistakes in Discharge Summaries

Some of the common mistakes in discharge summaries that can affect your health insurance claims process are.

  • Incomplete or vague summary
  • Incorrect patient details
  • Missing information on procedures or treatments
  • Difficult to read summaries
  • Inaccurate dates

How to Ensure Your Discharge Summary Is Insurance-Ready

The best way to ensure your discharge summary is insurance-ready is by avoiding common mistakes. Here's what you can do:

    • Request a typed or clearly written summary.
    • Ensure that all your details, including age, name, date of hospitalisation and discharge, etc., are accurate.
    • Confirm that accurate diagnosis and treatment details are mentioned.

What to Check Before Leaving the Hospital?

You should check all the important documents, including the discharge summary, before leaving the hospital. If you have any questions or concerns, please contact the hospital for clarification.

Conclusion

The discharge summary is not just a hospital document; its role extends beyond it. It is one of the most basic documents you will require to submit a health insurance claim. The health insurance claim process may seem tedious, especially when you are suffering from an illness. Knowing what a discharge summary is and how it impacts insurance claims can help minimise the chances of rejection.

Frequently Asked Questions

No, there are many other documents required to ensure a successful insurance claim. Some additional documents you will need include hospital bills, payment receipts, and doctor's prescriptions, among others.

While you can get insurance in some cases, it's challenging. Most insurers will reject your claim if the discharge summary for the insurance claim is missing.

You can request that your doctor's team correct it. Insurers will accept a correction if it is signed and stamped by the hospital.

You should keep the discharge summary for at least a few years for follow-up treatments or future insurance references.

Yes, a discharge summary is required even for daycare procedures that do not need an overnight stay.

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Roocha Kanade profile avatar

Written by

Roocha Kanade

Content Architect

Dr Nitin Kumar Gupta profile avatar

Reviewed by

Dr Nitin Kumar Gupta

SVP – Health Underwriting & Claims at Acko General Insurance

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ACKO Technology & Services Private Limited
CIN: U74110KA2016PTC120161
The use of images and brands are only for the purpose of indication and illustration.
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Car insurance
Bike insurance
Health insurance
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Enterprise solutions
Company
About us
Careers
Contact us
Board of directors
Brand Hub
All resources
Customer stories
Media Kit
Articles
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Legal
Financials & disclosures
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Car
Car insurance
Third party car insurance
IDV calculator
Comprehensive car insurance
Zero depreciation car insurance
Car insurance calculator
Car insurance check
Pay as you drive car insurance
Bike
Bike insurance
Third party bike insurance
Bike Insurance calculator
Check bike insurance validity
Scooter insurance
Used bike insurance
Comprehensive bike insurance
EV bike insurance
Own damage bike insurance
Vehicle services and more
Check & pay e-challan
Check vehicle details
Check vehicle PUC status
Recharge FASTag
Check RC status
Health, life, and other services
Health
Health insurance
Health insurance plans for family
Health insurance for parents
Health insurance premium calculator
Health insurance for senior citizens
80D Deduction
1 crore health insurance
Super top up health insurance
Mediclaim policy
Cashless health insurance
50 lakh health insurance
Critical illness health insurance
Compare health insurance plans
Waiting period in health insurance
Life
Life insurance
Term insurance
Term insurance tax benefit
1 crore term insurance
Term insurance calculator
Term insurance for single parents
Term insurance for senior citizens
Affordable term insurance
Critical illness rider life insurance
Accidental death benefit rider In life insurance
Disability income rider
Best term insurance in India
Best life insurance
Group health insurance
Employee health insurance
Group health insurance add-ons
Maternity cover in group health insurance
Group personal accident insurance
Group health insurance for startups
Corporate health insurance
Other services
ABHA
HLV calculator
Will creation service
Health card
ABDM
Ayushman card apply
Abha card registration
Rent receipt generator
Travel
Travel insurance
International travel insurance
Schengen travel insurance
Travel insurance for Dubai
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Enterprise
Health insurance for gig workers
Loan protection for fintechs
Group travel insurance
Auto insurance partnership
Electronic device insurance
Health insurance for corporates
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CIN: U74110KA2016PTC120161
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