• Step 1: Patient present for admission.
• Step 2: Filling up of the Pre Authorization Form by treating doctor and sending to TPA/Insurance Company concerned and waiting for initial approval. The estimated amount of expenditure is mentioned here.
• Step 3: TPA/Insurance Company may revert back with queries if any which are replied by the hospital.
• Step 4: TPA/Insurance Company sends provisional approval as per patient's policy details.
• Step 5: Patient is allowed to undergo treatment of the hospital as per approval.
• Step 6: Prior to discharge the final bill, treatment details & the discharge summary of the patient is sent to the TPA/ Insurance Company for final approval.
• Step 7: TPA/Insurance Company may have multiple queries which have to be replied to by the hospital. Approval is not sent till all queries have be answered and the TPA/ Insurance company is totally convinced that treatment has been done as per approval. Step & after final approval is received the patient is clear for discharge.

It is our endeavour to provide cashless benefit to our Insurance patients but due to many a reason the same may not be possible at times. You may be requested to make payments in the following situation;

Denial of your Claim by the Insurance Company/TPA. Hospital will not be responsible for such denial and in that case the patient will have to clear the hospital dues before discharge of the patient.

The TPA/Insurance Company may pay a part of the total bill. In that case the patient will have to settle the balance amount prior to discharge. Your policy may mention for a Co-Payment clause wherein the beneficiary will have to pay a part of the bill.

More than Insurance Companies/TPAs adopted a system of capping on bed charges to 1 % of the policy amount. If the beneficiary avails any facility beyond his/her entitlement then he/ she will have to pay the difference amount to the hospital prior to discharge.

Your Health Insurance Company/TPA does not pay for everything. Certain expenses like service charge, cost of diaper, hand gloves, extra food, telephone bill, nutritional supplements etc. are to be paid by the patients. These are called as NON ADMISSIBLE EXPENSES. Please refer to the annexure to know the common list of such non admissible expenses that you may have to pay for. For a detailed list of exclusions, please refer to your policy document.