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Insurance

insurance guidelines

Health-Insurance

Prashanth Hospitals is empanelled with most of the reputed insurance providers.

Cashless facility is subject to the conditions and terms in the policy.

The hospital offers the cashless option through the Healthcare Insurance Providers listed on our panel. If your insurance provider is not empanelled with us, we can help you with the reimbursement process. It is our aim to make your experience with us as smooth and pleasant as we can

To ensure that all our have an approval process, we work with a wide range of health insurance partners which allows patients to have a clear understanding of the coverage and the criterias therein and the quantum of coverage allowed.

PRE-ADMISSION AND ADMISSION REQUIREMENTS

In case of a planned admission, you would have first consulted a doctor, who in turn would have advised you on the probable date of hospitalization. In such a case, you must apply for approval of the estimated hospital expenses directly by your TPA at least 4-5 days prior to the date of hospitalization. Our Insurance Help Desk (Phone : ) will assist you through the pre-authorization procedure.

However, the Insurance Help Desk is only a facilitator and can in no way influence the decision on the approval. Your TPA may not grant approval due to any of the following reasons:

• If the ailment for which you are hospitalized is not covered in your policy

• If the information contained in pre-authorized form id insufficient to approve the request, though most of the time the TPA will request the hospital if additional information is needed.

DURING DISCHARGE

During discharge, you shall be required to

• Settle the difference, if any, if your bill exceeds the designated insurance amount

• You will be required to pay for all non-medical items as your policy will not cover them.

• Submit all the medical documents including the lab reports, claim forms, discharge summary and final bill to the hospital before being discharged.

The hospital, then, submits all necessary documents to TPA. TPA processes the bill on the basis of eligibility and actual cost. TPA makes the claim payment to the hospital and / or patient (as per the policy terms and actual cost). You shall then, be refunded the initial deposit amount with deduction if any.

What if the cost for treatment exceeds the approved sum?

Generally the TPA only approves a part of the expenses of the treatment and only after the hospital sends the final bill along with the discharge summary and other reports, does it approve the entire amount.

Sometimes the hospitals will request the TPA to increase the amount approved if needed during the treatment.

EMERGENCY HOSPITALIZATION

In an emergency hospitalization, the important thing is to get the patient treatment at the earliest.

The Insurance Help Desk will take up your case on a fast track basis with your TPA and will to receive approvals within ? hours during any working hours.

Step 1: Show your health insurance card and fill in the pre-authorization form.

Step 2: The TPA desk in the hospital will try to fast track the process for your cashless process but in case you cannot wait for the approval, you can pay a deposit and start the treatment and get the reimbursement later on.

Step 3: Generally the time to taken to process an emergency case is 6 hours, but will depend upon the insurance co / TPA. You need to follow up with the TPA if necessary to know the status of the request.

NAME OF TPAs
MEDIASSIST INDIA TPA PVT LTD
VIDAL HEALTHCARE SERVICES
FHPL TPA PVT LTD
UNITED HEALTH CARE
VIPUL MEDCORP TPA PVT LTD
HERITAGE TPA PVT LTD
MEDICARE TPA PVT LTD
RAKSHA TPA PVT LTD
MD INDIA TPA PVT LTD
GENINS INDIA PVT LTD
GOOD HEALTH PLAN TPA LTD
STAR ALLIED GENERAL INSURANCE
HDFC ERGO GENERAL INSURANCE
RELIGARE GENERAL INSURANCE
MAX BUPA GEENRAL INSURANCE
RELIANCE GENERAL INSURANCE
CHOLAMANDALAM GENERAL INSURANCE
ROYAL SUNDARAM GENERAL INSUANCE
DEDICATED HEALTH CARE TPA PVT LTD
NAME OF PUBLIC SECTOR
ONGC
HPCL
STATE GOVERNEMENT
CMCH SCHEME

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Prashanth Hospitals-Multispeciality Hospital in Chennai, Best Hospital in Chennai

Prashanth Hospitals-Multispeciality Hospital in Chennai, Best Hospital in Chennai