Health insurance policies offer cashless hospitalization facility and route your policy through third-party administrator (TPA). Our hospital is only a facilitator and has no authority to approve or disapprove any request for cashless hospitalization. Protocols laid down by the Insurance Regulatory and Development Authority (IRDA) will be adhered to strictly.
Procedure in Case of Planned Admission
In the case of a planned admission, you would have first consulted a doctor who in turn would have advised you on the probable date of hospitalization. In such a case, you must have applied for an approval of the estimated hospital expenses directly with your TPA at least 4-5 days prior to the date of hospitalization.
In case you have not applied for a pre-authorization sufficiently in advance or if the doctor treating you advises you to get hospitalized immediately after the consultation, our Insurance Help Desk will assist you through the pre-authorization procedure.
Procedure in Case of Planned Admission
At the Insurance Help Desk, you need to present the original health Insurance card issued to you by your TPA. And also produce a photocopy of ID proof issued by Govt. Authorities (PAN card/ Driving Licence/Voter ID card etc). In addition to this please produce your photocopy of the employee ID card if it is a corporate group insurance policy. Collect the pre-authorization forms pertaining to your TPA
Your pre-authorization will have two sections:
- General details on the health Insurance policy to be filled in by you (the Insurance desk will assist you in case you have any difficulty).
- Information pertaining to the treatment recommended for you-it needs to be filled in and duly signed by the Doctor who is treating you (do not attempt to fill this section, contact the Corporate desk in case of any difficulty)
- Return the completed form to the Insurance Help Desk. The personnel at the desk will verify the form for its completeness and let you know in case of any discrepancy
- Once the form is complete in all respects, the Insurance Help Desk will fax the form to the office of your TPA.
- The Insurance Help Desk will revert to you on the approval status.
Procedure in Case of Emergency Admission
In case of emergency hospitalization, the corporate help desk will take up your case on a fast track basis with your TPA and will assist you in receiving the approval during working hours. For cashless treatment, it is mandatory for the hospital to have approval from your TPA. In case of delay in receiving the approval or when you cannot wait for receiving the approval owing to medical urgency, you can undertake the treatment by paying the necessary cash deposit.
If you receive approval from your TPA after paying the cash deposit, you are entitled to a refund of the cash deposit.
What do I do if I do not get approval on my cost of treatment till the time of discharge at the Hospital?
Cashless hospitalization is linked to the approval of the estimated expenditure on your proposed treatment. In case you do not get your approval you will need to bear the entire expenditure incurred on the treatment. Therefore it is always prudent to get the approval and then get yourself admitted.
Under what circumstances will the request for cashless hospitalization not be entertained?
Normally your request for approval might be rejected when:
- The ailment for which hospitalization is being sought by you is not covered under your insurance policy for reasons like pre-existing ailment, specific exclusions (road traffic accident under the influence of Alcohol).
- Information contained in the pre-authorization form is insufficient for the TPA to arrive at a decision and further information is not available for various reasons.
- You have exhausted your eligible Medical Insurance cover for the year.
What do I do if the actual medical expenses overshoot the pre-approved amount?
In case your hospitalization expenses exceed the pre-approved amount, you can approach the Insurance Help Desk to apply for an enhancement of the pre-approved amount. The Insurance Help Desk will apply for an enhancement on your behalf with the TPA and provide the necessary documentation. In case you have not exhausted your medical insurance limit, it is most likely that your TPA will approve the application for the enhancement either for the requested enhanced amount or up to your insured limit after deducting the value already utilized by you during the year whichever is less.
If the TPA turns down the request for enhancement you will need to pay the amount incurred in excess of your approved amount directly to the hospital before the discharge.
Does cashless hospitalization cover all medical expenses?
No, there are few non-admissible items which will not be covered under cashless hospitalization. For complete details on the medical expenses that are covered, and those that are not covered, you need to go through your health insurance policy.
In case of cashless hospitalization, what are the documents the hospital requires from me at the time of discharge?
All the original documents including bills, lab reports, discharge summary and claim form. All the original documents duly signed by you need to be submitted to the hospital.
Our TPA & Corporate Tie-up Details
- Alankit Healthcare Ltd.,
- Apollo Munich Health Insurance Co Ltd.,
- Bajaj Alianz Insurance Co Ltd.,
- Cholamandalam Ms General Insurance Co. Ltd., Chennai
- Dedicated Healthcare Services Ltd.,
- E-Meditech Solutions Limited.,
- Family Health Plan Limited.,
- Good Healthplan Ltd.,
- H D F C Ergo General Insurance Co., Ltd.,
- Health India Tpa Services Pvt Ltd.,
- Icici Lombard Gic Ltd.,
- Md India Healthcare Services(Tpa)Pvt.Ltd.,
- Mdindia Healthcare Services (Tpa)Pvt Ltd.,(Tnnhis)
- Med Save Healthcare Tpa Ltd., Chennai
- Medi Assist India Pvt. Ltd.,
- Medicare Tpa Services (I) Pvt Ltd.,
- Paramount Health Services[Tpa]Pvt.Ltd.,
- Raksha Tpa Pvt.Ltd.,
- Reliance Genaral Insurance Company Ltd.,
- Religare Health Insurance Co Ltd.,
- Star Health & Allied Insurance Co.Ltd.,
- United Health Care Parekh Tpa Ltd.,
- Vidal Healthcare Services P.Ltd.,
- Vipul Medcorp Tpa Pvt.Ltd.,
- Aai - International Airports Division
- Air India Limited
- Air Port Authority Of India ( NAD )
- Andaman & Nicobar Shipping Services
- Ashok Leyland Limited
- Bharat Electronics Ltd.,
- Bharat Heavy Electrical Ltd.,
- Bharat Petroleum Corp. Ltd.,
- Brakes India Limited.,
- Chennai Petroleum Corpn.Ltd.,
- Chennai Port Trust Hospital
- Department Of Atomic Energy Hospital
- Dredging Corporation Of India Ltd.,
- Engineering Projects (I) Limited
- Gas Authority Of India Ltd.,
- H.H.E.C. Of India Limited
- Hindustan Aeronautics Ltd.,
- Hindustan Petroleum Corpn.Ltd.,
- Indian Airlines Limited
- Indian Oil Corp. Limited
- Indian Railway Catering & Tourism Corp.
- Industrial Developement Bank Of India
- Larsen & Toubro Limited
- Lucas T.V.S. Limited
- M.M.T.C. Limited
- M.R.F. Limited
- Madras Fertilizers Limited
- Mstc Limited S.R.O.
- National Mineral Devlop.Corpn.Ltd.,
- National Thermal Power Corporation Ltd.,
- Oil & Natural Gas Corp. Limited
- Pepsico India Holdings P.Ltd.,
- Reserve Bank Of India
- Rural Electrification Corporation Limited
- S.R.F Limited
- S.T.C.[The State Trading Corp.Of India Ltd]
- Shar Center
- State Bank Of India
- Steel Authority Of India Ltd.,
- Sundaram Brake Lining Med Centre
- Sundaram Clayton Medi Centre
- Tata Communications Ltd.,(VSNL)
- The Shipping Corp. Limited
- Tube Protects Of India
- Unit Trust Of India
- Wabco India Ltd.,