TPA Insurance / Mediclaim

Patients can avail the benefit of Cashless Hospitalisation at Bhatia Hospital.

Bhatia Hospital is empanelled with most of the reputed Insurance providers for easy payment. We would be glad to discuss payment options with your insurance provider, in case your policy covers services rendered away from your place of residence.

In case of emergency or planned admission for patients who are covered under health insurance, patient or his/her relatives are supposed to produce a valid TPA ID card and insurance policy copy and a valid Photo ID proof of the patient. Please refer to the list of insurance companies who offer TPA services for cashless treatments:

 

Empanelled TPA / Insurance Comp 

  • Paramount Health Services (TPA) Pvt. Ltd.
  • ICICI Lombard General Insurance
  • MD India Healthcare Services (TPA) Pvt. Ltd.
  • Health India TPA Services Pvt Ltd.
  • Apollo Munich Health Insurance Company Ltd. (Till A1 Class Only )
  • Raksha TPA Pvt Ltd
  • E Meditek TPA Services Ltd
  • Reliance General Insurance Company Ltd
  • Max Bupa Health Insurance
  • Religare Health Insurance
  • HDFC ERGO General Insurance
  • United Healthcare Parekh TPA
  • IFFCO-TOKIO General Insurance Company
  • ICICI Prudential Life Insurance
  • Future Generali India Insurance Co Ltd
  • Medsave Healthcare TPA Ltd.
  • Cholamandalam MS General Insurance Company Ltd
  • Vipul MedCorp TPA Pvt Ltd
  • Ericson TPA
  • East West Rescue
  • Heritage Health TPA Pvt. Ltd
  • Universal Sompo General Insurance Company Ltd
  • Rothshield Healthcare TPA Ltd
  • CignaTTK Health Insurance
  • Star Health Insurance (Only for JIO)
  • Liberty General Insurance
  • TATA AIG 
  • Adity Birla Insurance 

 

 

PLANNED ADMISSION:

  • The patient/patient's relative is required to fill a Pre – Authorization Form and submit it to TPA Dept (Ground Floor) 4 Days prior along with below mentioned document.

Preauthorization includes: 

  • Basic Information: Filing Pre – Authorization and submit it to TPA Dept, Our TPA team will assist you in case of any difficulty
  • Medical Information: Form of Treatment recommended by the Consultant is to be duly ffilled & signed by the treating doctor
  • Documents to be submitted : 
    • Admission Note
    • Relevant Investigation report
    • Insurance Id Card
    • Pre – Authorization form signed by the Treating Doctor
    • Photo Id proof
    • Recent Passport size photo

           Post documentation formalities, it will be processed to the respective Insurance / TPA

  • Revert to TPA / Insurance company :
    • Initial Approval: It will be informed to you via mail / sms
    • Queries: Our team will get in touch with you to resolve it.
  • Patients need to pay the deposit as per hospital policy based on the class of admission & type of surgery. It will be refunded to the patient as per refund policy for medicalim patients

 

EMERGENCY ADMISSION:

  • Priority admission and treatment will be provided to the patient in case of emergency.
  • The cashless process has to be initiated within 24 Hrs of the admission.
  • Patients need to pay the deposit as per hospital policy based on the class of admission & type of surgery. It will be refunded to the patient as per refund policy for medicalim patients.
  • The patient/patient's relative is required to fill Pre – Authorization Form and submit it to TPA Dept (Ground Floor) along with below mentioned document.
  • Preauthorization includes:
    • Basic Information: Filing Pre – Authorization Form and submit it to TPA Dept, Our TPA team will assist you in case of any difficulty
    • Medical Information: Form of  Treatment recommended by the Consultant  is to be duly filled & signed by the treating doctor
    • Documents to be submitted:
      • Admission Note
      • Relevant Investigation report
      • Insurance Id Card
      • Pre – Authorization form signed by the Treating Doctor
      • Photo Id  proof
      • Recent Passport size photo

           Post documentation formalities, it will be processed by the respective Insurance / TPA

  • Revert to TPA / Insurance company:
    • Initial Approval: It will be informed  to you via mail / sms / call
    • Queries: Our team will get in touch with you to resolve it.

 

DURING STAY:

  • If the patient's bill exceeds the sanctioned amount, an estimation of additional expense will be sent to the TPA / Insurance Company, however, if no enhancement is received from the TPA / Insurance Company, the patient will have to pay the exceeding amount.
  • If the TPA / Insurance Company intimates that the sum insured is exhausted the patient needs to pay the exceeding amount.
  • Authorization letter received from TPA / Insurance Company for cashless hospitalization is only tentative. TPA/ Insurance Company can deny the claim for any reason during the hospital stay. The patient will be responsible for payment of the Hospital bills.

 

DISCHARGE PROCESS:

  • Once the treating consultant gives the discharge, the patient's final bill along with the discharge summary will be sent to respective TPA / Insurance Company
  • On receiving the final approval the patient's discharge process will be complete (This process tentatively more that 5 Hrs)
  • The patient is required to pay for the non payable items. As these are not covered under their Insurance policies and the amount towards security deposit. 
  • No original document / reports of hospitalization will be handed over to the patient as these are to be send to the TPA / Insurance Company (Xerox can be collected from the Hospital )

 

DENIAL:

  • Once the hospital gets a denial from the TPA / Insurance Company the patient will be treated as a cash paying patient.

 

 

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