Empanelled Corporate/TPA/Insurances

Empanelled Corporate/TPA/Insurances

TPA Image
TPA Image

Our hospital has some of the leading corporates and TPA or insurance companies to help our patients with cashless and hassle-free hospitalization. With our long-term association with the companies, we ensure to deliver the best services to our patients.

Documents Required at
the time of admission Pass

  • TPA I-Card/E-Card of the patient.
  • Any Govt. Issued photo ID card. (Prefer: Pan Card &
    Aadhar Card)
  • Authorization letter (if planned admission)
  • Current year policy papers.

Our hospital has some of the leading corporates and TPA or insurance companies to help our patients with cashless and hassle-free hospitalization. With our long-term association with the companies, we ensure to deliver the best services to our patients.

Documents Required at
the time of admission Pass

  • TPA I-Card/E-Card of the patient.
  • Any Govt. Issued photo ID card. (Prefer: Pan Card & Aadhar Card)
  • Authorization letter (if planned admission)
  • Current year policy papers.

Patients will be admitted under cashless in the hospital based on I-Card issued by the INSURANCE CO./TPA’s who have tied up with the hospital for providing cashless treatment for its clients.

Patients getting admitted in Emergency will be admitted based on E-card/policy paper following the admission patient preauthorization request is sent to their concerned TPA/ Insurance Co, however it is the responsibility of the patient to get the AUTHORISATION LETTER to the hospital from the concerned TPA/Insurance co.

All TPA patients will be considered as REGULAR and will have to pay all necessary charges till initial authorization is received from the concerned TPA or insurance company. The entire amount paid during the admission period will be adjusted or refunded at the time of discharge, subject to verification of the final approval received at the time of discharge.

It is the sole responsibility of the patient or patient’s relative to intimate hospitals TPA desk within 12 hours of admission about he/she being a TPA cardholder. Any delay in informing the hospital about the same, can lead to the rejection of such case from concerned TPA/ Insurance co.

Getting the Authorization is the primary responsibility of the patient and hospital may only facilitate the patient in getting the AUTHORISATION LETTER. Hospital will only process the documents related to cashless and the patient / patient’s relative need to follow up with their respective TPA /Insurance company and arrange for the authorization letter to be mailed to the hospital at the earliest.

All planned admission will be entertained based on INTIAL AUTHORISATION LETTER, which will be verified by Dept. of corporate relation (TPA desk) prior to getting admitted and subsequently to be produced at admission counter at the time of admission and at all concerned places.

On the day of discharge, patients discharge card and final bill needs to be sent to their concerned TPA/ Insurance co. for final authorization. Patient may have to wait for longer period till we receive the authorization letter from the TPA. However, if the final authorization does not reach us within 4 hrs. of sending mail or uploading the discharge summary and final bill on respective TPA/ Insurance portal, the said patient must pay the hospital bill in full and claim for reimbursement.

Cashless processing will only happen between 10 am to 8 pm during working hours.

In case of communication set up failure (i.e., telephone lines, internet etc.) arising out of unavoidable circumstances at hospital or TPA end, the hospital will not take any responsibility for any eventualities arising out of the same. (In such cases patients need to do full payment and go for reimbursement)

If final approval is not received to hospital till 8pm from respective TPA/ Insurance co. then patient needs to pay the final bill amount and need to go for reimbursement.

There will be no cashless processing on Sundays, Public & Hospital Holidays.

In case TPA rejects or there is delay in receiving AUTHORISATION LETTER within 2-3 days of admission, then the patient will have to bear his/her hospital bills and will not be entitled for any Cashless/Credit facility. However, they can put the file for reimbursement.

For GIPSA Patients if duration of stay increases or there is a change in treatment apart from Package, in such case all charges above than package should be bear by the patient or patient’s relative.

In case the patient/relative receives message (SMS) regarding approval on their mobile, it will not be considered as authorization. The cashless facility of the patient will purely depend on the authorization letter send via email (on their letterhead) to our hospital by the TPA/Insurance company or uploaded on the portal of TPA/ Insurance company.

Cost occurring due to change in treatment or additional treatment or bill amount crossing the sanctioned limit may not be paid by the TPA and will have to be settled by the patient from time to time.

Actual facts will be furnished to the TPA in the Pre Auth form for which the patient is admitted and any request for alteration by the patient or their relative in the pre auth will not be entertained which does not match with concerned treatment or ailment.

Please note that there are certain investigations like MRI, pathological tests etc. which are done outside the hospital for which the patient will have to bear the cost and the same will be adjusted or refunded once we receive payment from the company.

In case patient takes a discharge against medical advice (LAMA), then in such scenario cashless service will not be applicable and the bill will have to be settled in full.

In case of a death of a TPA/Insurance patient on Sunday, Public or Hospital Holiday, cashless facility will be processed only on next working day. In such scenario patient’s relative needs to settle the bill in full to the hospital and may go for reimbursement.

If a patient gets a transfer to other hospital, then they will have to settle the bill amount in full. The amount so paid will be adjusted only if we get the approval within 4 hrs. of sending the final bill and discharge documents to the TPA or Insurance co.

A minimum non-interest-bearing security deposit of 15% of the final approved amount will be collected at the time of discharge from the TPA patient. If the patient’s stay increases beyond 21 days, the security deposit will be 20%. This deposit is collected towards non-medical and other expenses that are not borne by the TPA/ insurance companies. This amount will be adjusted only after the hospital receives payment towards the bill from the respective TPA.

TPA/Insurance Company may deduct administrative charge (10% of hospital bill excluding pharmacy amount), admission charge, pharmacy charges and other items charged in your final bill considering them as Non-Medical Items and such deductions to be paid by the patient.

Estimate given at the time of pre auth can be revised or change due to change in diagnosis/medical treatment during patient stay & in such case difference amount if not approved by TPA/ Insurance company the same needs to be borne by the patient.

25% extra charges will be applicable on emergencies surgeries and surgeries performed between 6pm to 8am on Sunday, public & hospital holidays.

TPA patients need to pay the difference of the bill amount if the patient admitted to and approval received is for different class. This will be applicable not only to bed charges but also to all other charges included in the bill.

If patient is transferred from lower class to higher then all the charges except pharmacy and bed charges will be applicable as per the higher class from the date of admission.

It is the responsibility of TPA patient to make payment within 7 days of hospital intimation, if your concerned TPA/Insurance co. makes part payment or defaults in payment or delay in making the payment within 60 days after sending the file for claim from hospital side to your TPA/Insurance co.

It is patient or patients relative responsibility to give proper detail regarding the sum assured, co-payment and inclusion or exclusion about the insurance policy, failing which cashless may be denied by the TPA/Insurance co.

The patient should get oriented about his/her insurance policy Terms & Conditions from the agent /TPA/Insurance Company and not from the hospital.

In case of planned surgery or admission it is responsibility of the patient to get prior approval from the TPA/Insurance co.

* For further information contact dept. of customer relation on 71452453/2454.
  • Patients will be admitted under cashless in the hospital based on I-Card issued by the INSURANCE CO./TPA’s who have tied up with the hospital for providing cashless treatment for its clients.

  • Patients getting admitted in Emergency will be admitted based on E-card/policy paper following the admission patient preauthorization request is sent to their concerned TPA/ Insurance Co, however it is the responsibility of the patient to get the AUTHORISATION LETTER to the hospital from the concerned TPA/Insurance co.

  • All TPA patients will be considered as REGULAR and will have to pay all necessary charges till initial authorization is received from the concerned TPA or insurance company. The entire amount paid during the admission period will be adjusted or refunded at the time of discharge, subject to verification of the final approval received at the time of discharge.

  • It is the sole responsibility of the patient or patient’s relative to intimate hospitals TPA desk within 12 hours of admission about he/she being a TPA cardholder. Any delay in informing the hospital about the same, can lead to the rejection of such case from concerned TPA/ Insurance co.

  • Getting the Authorization is the primary responsibility of the patient and hospital may only facilitate the patient in getting the AUTHORISATION LETTER. Hospital will only process the documents related to cashless and the patient / patient’s relative need to follow up with their respective TPA /Insurance company and arrange for the authorization letter to be mailed to the hospital at the earliest.

  • All planned admission will be entertained based on INTIAL AUTHORISATION LETTER, which will be verified by Dept. of corporate relation (TPA desk) prior to getting admitted and subsequently to be produced at admission counter at the time of admission and at all concerned places.

  • On the day of discharge, patients discharge card and final bill needs to be sent to their concerned TPA/ Insurance co. for final authorization. Patient may have to wait for longer period till we receive the authorization letter from the TPA. However, if the final authorization does not reach us within 4 hrs. of sending mail or uploading the discharge summary and final bill on respective TPA/ Insurance portal, the said patient must pay the hospital bill in full and claim for reimbursement.

  • Cashless processing will only happen between 10 am to 8 pm during working hours.

  • In case of communication set up failure (i.e., telephone lines, internet etc.) arising out of unavoidable circumstances at hospital or TPA end, the hospital will not take any responsibility for any eventualities arising out of the same. (In such cases patients need to do full payment and go for reimbursement)

  • If final approval is not received to hospital till 8pm from respective TPA/ Insurance co. then patient needs to pay the final bill amount and need to go for reimbursement.

  • There will be no cashless processing on Sundays, Public & Hospital Holidays.

  • In case TPA rejects or there is delay in receiving AUTHORISATION LETTER within 2-3 days of admission, then the patient will have to bear his/her hospital bills and will not be entitled for any Cashless/Credit facility. However, they can put the file for reimbursement.

  • For GIPSA Patients if duration of stay increases or there is a change in treatment apart from Package, in such case all charges above than package should be bear by the patient or patient’s relative.

  • In case the patient/relative receives message (SMS) regarding approval on their mobile, it will not be considered as authorization. The cashless facility of the patient will purely depend on the authorization letter send via email (on their letterhead) to our hospital by the TPA/Insurance company or uploaded on the portal of TPA/ Insurance company.

  • Cost occurring due to change in treatment or additional treatment or bill amount crossing the sanctioned limit may not be paid by the TPA and will have to be settled by the patient from time to time.

  • Actual facts will be furnished to the TPA in the Pre Auth form for which the patient is admitted and any request for alteration by the patient or their relative in the pre auth will not be entertained which does not match with concerned treatment or ailment.

  • Please note that there are certain investigations like MRI, pathological tests etc. which are done outside the hospital for which the patient will have to bear the cost and the same will be adjusted or refunded once we receive payment from the company.

  • In case patient takes a discharge against medical advice (LAMA), then in such scenario cashless service will not be applicable and the bill will have to be settled in full.

  • In case of a death of a TPA/Insurance patient on Sunday, Public or Hospital Holiday, cashless facility will be processed only on next working day. In such scenario patient’s relative needs to settle the bill in full to the hospital and may go for reimbursement.

  • If a patient gets a transfer to other hospital, then they will have to settle the bill amount in full. The amount so paid will be adjusted only if we get the approval within 4 hrs. of sending the final bill and discharge documents to the TPA or Insurance co.

  • A minimum non-interest-bearing security deposit of 15% of the final approved amount will be collected at the time of discharge from the TPA patient. If the patient’s stay increases beyond 21 days, the security deposit will be 20%. This deposit is collected towards non-medical and other expenses that are not borne by the TPA/ insurance companies. This amount will be adjusted only after the hospital receives payment towards the bill from the respective TPA.

  • TPA/Insurance Company may deduct administrative charge (10% of hospital bill excluding pharmacy amount), admission charge, pharmacy charges and other items charged in your final bill considering them as Non-Medical Items and such deductions to be paid by the patient.

  • Estimate given at the time of pre auth can be revised or change due to change in diagnosis/medical treatment during patient stay & in such case difference amount if not approved by TPA/ Insurance company the same needs to be borne by the patient.

  • 25% extra charges will be applicable on emergencies surgeries and surgeries performed between 6pm to 8am on Sunday, public & hospital holidays.

  • TPA patients need to pay the difference of the bill amount if the patient admitted to and approval received is for different class. This will be applicable not only to bed charges but also to all other charges included in the bill.

  • If patient is transferred from lower class to higher then all the charges except pharmacy and bed charges will be applicable as per the higher class from the date of admission.

  • It is the responsibility of TPA patient to make payment within 7 days of hospital intimation, if your concerned TPA/Insurance co. makes part payment or defaults in payment or delay in making the payment within 60 days after sending the file for claim from hospital side to your TPA/Insurance co.

  • It is patient or patients relative responsibility to give proper detail regarding the sum assured, co-payment and inclusion or exclusion about the insurance policy, failing which cashless may be denied by the TPA/Insurance co.

  • The patient should get oriented about his/her insurance policy Terms & Conditions from the agent /TPA/Insurance Company and not from the hospital.

  • In case of planned surgery or admission it is responsibility of the patient to get prior approval from the TPA/Insurance co.

Corporates
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Insurance Company
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TPA’s (Third Party Administrator)
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Note: (*) Before admission please confirm with Hospital TPA desk, for empanelment status of the marked companies.
Note: (*) Before admission please confirm with Hospital TPA desk, for empanelment status of the marked companies.