Procedure for cashless claim:
Cashless claim facility is available only with network hospitals.It can be a planned hospitalization or an emergency hospitalization.
In case of emergency hospitalization:
- Show the TPA identity card and any photo identity card for the reason of identity proof at the hospital.
- Submit a pre-authorization form to hospital after it is completely filled and signed by the treating doctor.
- Hospital will stamp the form and fax it to TPA for authorization.
- After investigation TPA will fax the approved cashless authorization letter to the hospital specifying the amount that can be expended by the hospital.
- In case the total hospitalization expenditure increases the amount authorized, the hospital will ask TPA for authorization from, giving reasons for the increase, at least one hour before the patient is to be released.
- If cashless is not approved by TPA, settle all the bills of hospital and apply for reimbursement.
In case of planned hospitalization:
- Show the TPA identity card and any photo identity card for the reason of identity proof at the hospital.
- Approach the hospital in advance and obtain the pre-authorization letter from the TPA 3-4 days prior to Date of Admission.
- Go to the hospital at least 72 hours before admission and provide them the following details: cashless Card, Letter from the consulting Doctor stating the Diagnosis, Date of Admission.
- Submit a pre-authorization form to hospital after it is completely filled and signed by the treating doctor.
- TPA will issue a Letter of Guarantee directly to the hospital, specifying the amount that can be expended by the hospital.
- Kindly note that the letter of guarantee are valid only for a period of 7-15 days from the date of its issue.
