City Hospital is a Tertiary Care Hospital to be recognized by the following Govt. Insurance Companies for cashless
CGHS Pensioner/Serving
CSMA
WCR
Airport Authority Of India
Cantonment Board
ECHS
Ayushman Bharat
List of TPA’s / Insurance companies/International Insurance Companies
The Oriental Insurance Company
United India Insurance
National Insurance Company
SBI General Insurance
Star Health and Allied Insurance
Raksha Health Insurance TPA Pvt.Ltd
MD INdia TPA Pvt.Ltd
Medsave TPA
Paramount TPA
Apollo Munic/HDFC Ergo
R-Care Insurance Pvt.Ltd
Ifco Tokyo General Insurance
Royal Sundaram General Insurance
(City Hospital Reserves the right to deny the Cashless Facility to any of the Card Holders of Above Mentioned TPA’s.)
Hospitalization benefit for TPA Patients
Patients can avail of the benefit of Cashless hospitalization at City Hospital if the TPA that the patient is covered by is tied up with the hospital.
How to identify your TPA?
There are several ways to identify your TPA:
The TPA will issue you an identity card which will indicate the name of your TPA.
On your insurance policy, on the lower left hand corner of the policy, the name of the TPA will be printed.
Your insurance agent will be able to inform you accurately.
Important points to Note:
Possessing a TPA identity card does not automatically entitle the patient to get Cashless benefit. A certain defined procedure for obtaining sanction from the TPA has to be followed.
During hospitalization:
The patient must give a proper and true medical history to the doctor at the time of filling in the pre authorization form, since any discrepancy may result in the denial of the claim and cancellation of the approval.
In case the patient is transferred to ICU/ICCU/ Recovery room and wants to retain the original bed then patient will have to keep an additional security deposit, depending on the class and number of days in ICU/ICCU/Recovery Room, as the TPA does not pay for dual occupancy.
Receiving an authorization letter for Cashless benefit is only tentative. If the claim is denied for any reason by the insurance company during the course of treatment or after patient is discharged, patient will be responsible for payment of the hospital bills, as per the undertaking which the hospital collects at the time of registration under respective TPA.
If the patient bill exceeds the sanctioned amount, an estimate for the additional amount will be sent to the TPA. However, it is primarily the responsibility of the patient / relative to keep track of the bill. If no enhancement is received from the TPA, the patient will have to pay for the bill amount over and above the sanctioned amount by the TPA.
Discharge process:
The hospital shall collect payment for all exclusions / non-medical expenses / surcharge, if they are not covered by TPA at the time of discharge.
No original hospital documents or reports will be given to patient, since these are sent by the hospital to TPA along with the bill for reimbursement. Xerox copies of the same can be taken by the relative at his own cost.
At the time of Discharge, the patient can collect a copy of detailed bill / summary from the accounts department.
Any pending reports or films should be collected from the TPA department within 30 days of discharge.
Denial process:
On denial of Cashless hospitalization by the TPA, the patient will be treated as a cash paying patient and will have to make the necessary payments as per hospital policy.