Cashless / direct billing: meaning in health insurance
แฟกซ์เคลม (ไม่ต้องสำรองจ่าย)
Cashless or direct billing means the hospital bills the insurer directly, so you do not pay the covered costs upfront.
How cashless works
In a hospital of the insurer's network, you show your insurance card and passport. The hospital sends the case to the insurer (in Thailand this is often called a “fax claim”) and receives a guarantee of payment. At discharge, you pay only what is not covered: deductible, items excluded, or costs above the limits.
Planned and emergency admissions
For planned treatment, ask for pre-authorisation a few days in advance. In an emergency, the hospital contacts the insurer after admission. If the insurer has not confirmed in time, the hospital may ask for a deposit that is refunded later.
Reimbursement outside the network
Outside the network, you pay the hospital and send a claim with the original receipts, itemised bill and medical certificate. Keep copies of everything.
General definition: the exact rules are those of your policy wording.
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