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POLICIES FOR INSURANCE PATIENTS

  • Please contact our Insurance Desk for submitting the relevant documents at least 2 days before admission.  The Insurance Desk will obtain preauthorization.

  • The patient must give a proper and true medical history to the doctor at the time of filling in the pre-authorization form. Any discrepancy may result in the denial of the claim and cancellation of the approval

  • A deposit of INR 5000/- will be collected as nonmedical expenses.  This will be reimbursed after the insurance company settles the claim.

  • In case the patient is transferred to ICU and wants to retain the original bed, then the patient will have to keep an additional security deposit depending on the type of bed and the number of days in the ICU as the Third Party Administrator (TPA) doesn’t pay for dual occupancy

  • All non-admissible expenses/exclusions have to be paid by the patient. Co-pay, value of disallowed items (disposables, dietary supplements, food etc.,) needs to be paid at the time of discharge.

  • Discharge formalities will not be taken up after 5 p.m. for insurance patients as TPA’s and insurance companies stop processing claims at 5 p.m. 

  • A processing fee of INR 350 will be charged to the patient for processing each insurance claim.

  • During the period of treatment, the patient’s attendants should keep in touch with our insurance desk on a regular basis to know the developments and answer queries if any.

  • Patient/attender should enquire about the below details from the Insurance provider/TPA before admission: limit of cover, co-payment, room rent restriction including nursing charges, Extra procedures or overstay and disallowances.

  • If the claim is denied by the insurance company/ TPA, the hospital shall not be responsible for such denial and the patient will have to clear the dues before discharge

  • If the insurance company/ TPA pays a part of the total bill, the balance will have to be settled by the patient before discharge

  • If the patient’s insurance policy has a co-payment clause, the patient will have to pay the co-payment.

  • Most health insurance companies/ TPA’s cap the bed charges covered to 1% of the policy amount. If the patient avails any facility beyond his/her entitlement, then he/she will have to pay the difference amount to the hospital before discharge

  • Patient will have to stay in the hospital for a few hours till the insurance department receives the final approval/sanction from the Insurance company/TPA. In case of any query from the Insurance provider, the process gets delayed by 4 to 6 hours every time

  • In case, the patient is admitted under emergency, then the required documents must be submitted to the insurance billing department within 24 hours of admission. The Hospital will not be responsible for denial of the claim by the insurance company/TPA due to delayed submission of the documents

  • No original hospital documents or reports will be given to the patient since these are sent by the hospital to the insurance company/TPA along with the bill, for reimbursement 

  • Insurance patients will leave the hospital premises only on receiving the final approval from their respective insurance companies.

  • Insurance patients cannot be discharged on Sundays and Government General Holidays.

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