Medical Insurance Cell

 

Caritas Hospital will be pleased to provide Cashless Medical Insurance (Mediclaim) & Reimbursement services to patients who have health insurance policies. Caritas Hospital has tied up with the following insurance companies, third party administrators and govt organizations to provide cashless service. 

List of TPAs and other Schemes for Cashless Treatment:-

   

 

 

Other Corporate Tie-ups for Cashless Treatment

Cashless in-patient treatment is subject to the approval from the TPA Company. solely as per their instructions- The patient or his / her relatives are advised to inform Insurance Cell regarding mediclaim and TPA prior to the admission and to get pre-authorization form. The Pre-authorization form should be filled carefully and duly signed by the insured and treating doctor. The approval from the TPA Co. should be obtained prior to the admission. In emergency, soon after the admission and no later than 24 hours TPA Company should be notified. In other words in any case duly filled and signed Pre-authorization form should be faxed or e-mailed to TPA Company within 24 hours of admission. Copy of I.D. card issued from the TPA and a valid photo ID proof (PAN Card, Driving License, Voters ID Card, Passport, Adhar Card etc.)  should be submitted to Insurance Cell with the completed Pre-authorization form. In case of failed to inform the TPA Company within the stipulated period or deniel from the TPA Company, the patient will be treated as normal cash paying patient. 

Routine Admission
When a routine hospitalization is needed the staff at the insurance cell will guide the patient / attendant to correctly fill up the details. The treating doctor or consultant too will fill up the details as applicable, sign the form and send it to the insurance cell for being transmitted to the concerned insurance company or TPA to obtain approval.

Emergency Admission
For emergency admission, the patient can get admitted by producing the mediclaim ID card. The insurance cell will scrutinize the ID card and coordinate with the concerned departments and advise the insurance company and TPA and get the necessary sanction. However, if emergency admission is required, then the patient/attendant has to deposit security money as per requirement of the case to case.

Hospitalization
During the course of procedure or surgery, if the patient requires additional treatment, procedure or surgery, the surgeon will notify the same to the patient's attendants and insurance cell to send fax request to the TPA or insurance company seeking additional sanction. If the additional sanction as sought is not made by the insurance company or TPA, the patient's attendants will have to make such payment to the hospital immediately, so that the requisite additional procedure could be carried on without any delay and interruption. The patients are requested to reveal their past history, details of treatments taken in the past, details of surgeries undergone, details of allergy to certain medicines, For ADULTS photo ID proof is required i.e PAN Card, Driving License, Voters ID Card, Passport, Adhar Card etc. And for MINORS i.e Photo ID of school/ration card or previous TPA ID card of the patient. This will help the insurance department to incorporate the details as applicable in the pre-requisition form.

Discharge Formalities
The patient or the patient's attendant should settle all disallowable items to the cashier. If the patient has undergone some surgery or procedure which has not been authorized by the insurance company, the patient will have to wait in the hospital till such time the approval comes from the insurance company or TPA for the additional amount. If the sanction obtained is for a lesser amount, the difference will have to be paid by the patient or his attendant. If the additional request is rejected, the expense incurred for performing such additional surgery or procedure will have to be paid by the patient or his attendant.

For more Details Contact:
Office no: 0481 2790025 to 29 Extn no:1323
Email:insurance.caritashsp@gmail.com

Virtual Tour