About TPA & Corporate
POLICIES AND GUIDELINE
GETTING PRE-AUTHORIZATION APPROVAL FROM YOUR TPA IS A MUST BEFORE YOU CAN GET CASHLESS ADMISSION TO THE HOSPITAL
- It is therefore necessary for you to approach our Insurance desk as soon as your consultant has advised admission. It is recommended that you apply your pre-authorization from your TPA at least 4 to 7 days prior to your date of admission.
- Insurance desk will give you a pre-authorization form, which you will have to get filled up from your consultant and return to your Insurance desk. It is strongly advised that you directly interact with your consultant in this regard. This will be faxed to your TPA for approval.
- You will get Cashless admission only after receipt of the approval from your TPA (except in Emergencies*). This process may take 24 to 48 hrs. depending upon your TPA.
*In an emergency we will admit the patient as a Cash Patient until approval is received, a deposit amount will need to be paid. In case of surgical admission, full OT amount needs to be paid in cash. If approval amount is less than the surgery amount then the difference amount need to be paid in cash. The deposit amount will then be returned at the time of discharge after deducting the non-medical and inadmissible expenses, which are governed by the terms of your provider.
STEPS TO A HASSLE FREE CASHLESS HOSPITALIZATION
Always keep in touch with the Insurance Desk and cooperate with them. Kindly complete the formalities as given by the Insurance Desk at the Front Office. Our Corporate Desk will assist you through the pre-authorization procedure. After receiving your cashless pre-authorization request form, your TPA can raise queries. To answer these we will require your complete corporation. Since approvals of claims are entirely at the discretion of the TPA/Insurance Companies, quarries may be raise by them. These are to be replied by the hospital on merit. In doing so, you may also be asked for additional information for securing approval(s). This is a time consuming process and hospital is only a facilitator. Your patience in this regard is appreciated. You will be asked to submit necessary documents which, you are requested to submit at the earliest to the Insurance Department.