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.
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, 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.
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|