Health insurance is a great support in times of illnesses or medical emergencies that require hospitalization.
When seeking admission at the hospital, do provide details of your health insurance at the registration desk. Please note it is important that you understand the terms of your policy and what it covers.
Most such policies mandatorily require 24 hours in-patient stay, except for specified day care procedures. Most preliminary investigations are generally not covered under health insurance. Insurance companies do not pay for non-medical expenses like toiletries, cosmetic items, buds, masks, housekeeping charges, admission charges, attendant/registration charges, medical certificate, MLC charges, attendant room charges etc.
In case patient stays in a room beyond his/her entitled limit as per health policy (1% of sum insured for basic room and 2% for ICU- inclusive of room & nursing charges, for most companies), the Insurer/TPA may deduct a proportionate amount from the total bill amount.
It is strongly advised that you discuss the terms of your health cover with our TPA desk and should you have any doubts, do please understand the benefits that will be provided to you under your specific health policy from the insurance provider
The TPAs/Insurance companies may deny cashless cover based on certain exclusions like pre- existing ailments, policy exclusions, under the influence of alcohol, AIDS/ HIV related treatments, sum insured exhausted, psychiatric treatments etc.
Patient has to get the pre-authorization form from the insurance helpdesk or from private clinic areas. In case of admissions through casualty counters, the insurance helpdesk is to be approached before close of office hours on the subsequent day to complete formalities.
The pre-authorization form has to be duly filled in by the patient and the treating doctor and handed over to the insurance helpdesk. The pre-authorization form has to be accompanied with TPA ID card / policy copy of the patient, photo ID proof (pan card, driving license, ration card, aadhaar card), supportive investigation reports & outpatient consultation papers.
In case of RTA / accident, patient has to provide following:
- FIR / MLC / AR
- Narration of accident – when, where & how, should be clearly provided through a letter
- Consumption of alcohol / drugs – a letter from the first treating doctor, certifying whether the patient was under the influence of drugs / alcohol at the time of accident.
- If SRMC is not the first treating hospital visited by patient, please produce a letter from first treating doctor.
Insurance companies / TPAs take up to 24 hours for approval on weekdays, this can extend to 2/3 days if they raise queries. However, we constantly follow up with the insurer, we have a turnaround time of less than 3-6 hours for almost 85% of the cases.
Please note until approval from TPA is received, the patient will be treated as cash payment case and patient will be liable to pay all initial deposits as required as per hospital rules. The amount paid towards such deposits can be adjusted and refunded at the time of discharge.
After receipt of approval, credit shall be extended and the same will be reviewed and interim requests for enhancement may be sought from TPA or the patient may be asked to make payments.
- Dedicated Healthcare Services TPA (India) Pvt Ltd
- E-Meditek TPA Services Pvt Ltd
- Family Health Plan (TPA) Limited
- Genins India TPA Ltd
- Good Health Plan TPA Services Limited
- Alankit Health Care TPA Limited
- Health India TPA Pvt Ltd
- Heritage Health TPA (P) Ltd
- Md India Health Care Services (TPA) Pvt Ltd
- Medi Assist India TPA Pvt Limited
- Medicare T.P.A Services (I) Pvt. Ltd
- Medsave Health Care TPA Limited
- Paramount Health Care Management Ltd
- Paramount Health Services TPA (P) Ltd
- Raksha TPA Pvt Ltd
- United Health Care India Pvt Ltd
- United Health Care Parekh TPA Pvt Ltd
- Vidal Health TPA Pvt Ltd
- Vipul Med Corp TPA Pvt.Ltd
- Park Mediclaim TPA (P) Ltd
- Aditya Birla Health Insurance Co Ltd
- Apollo Munich Health Insurance Co Ltd
- Bajaj Allianz General Insurance Co Ltd
- Bharti Axa General Insurance Co Ltd
- Cholomandalam Ms General Insurance Co Ltd
- Future Generali India Insurance Company Ltd
- Hdfc Ergo General Insurance Company Limited
- Icici Lombard General Insurance Company Ltd
- Iffco Tokio General Insurance Company Ltd
- Liberty Videocon General Insurance Co Ltd
- Max Bupa Health Insurance Company Limited
- National Insurance Company Ltd
- New India Assurance Co Ltd
- Oriental Insurance Co Ltd
- Reliance General Insurance Company Ltd
- Religare Health Insurance Co Ltd
- Royal Sundaram General Insurance Co Ltd
- Star Health & Allied Insurance Co Ltd
- United India Insurance Company Ltd.
- Universal Sompo General Insurance Co Ltd