Insurance & TPA Information

Important cashless, TPA, approval, discharge, and reimbursement rules for patients and relatives.

Our hospital has some of the leading corporates and TPA or insurance companies to help our patients with cashless and hassle-free hospitalization. With our long-term association with the companies, we ensure to deliver the best services to our patients.

Policy details

Clear guidance on authorisation, billing, and reimbursement.

Understand the insurance process before admission, during treatment, and at discharge.

Policy section

Cashless admission basics

Cashless admission is available only for insurers or TPAs tied up with the hospital and is subject to authorisation.

Carry insurance card, TPA card, e-card, or policy papers at admission.
The hospital TPA desk must verify the approval before cashless admission.
Until initial authorisation is received, the patient is treated as a regular patient and required charges must be paid.
Amounts paid may be adjusted or refunded only after final approval and payment from the TPA or insurance company.

Policy section

Planned admissions and prior approval

Planned admission is processed only with an initial authorisation letter.
The Department of Corporate Relations or TPA desk verifies the letter before admission.
For planned surgery or admission, prior approval must be arranged by the patient or relative.
Approval documents must be shown at the admission counter and wherever required.

Policy section

Discharge, delay, and reimbursement rules

On discharge day, the discharge card and final bill are sent to the TPA or insurance company for final approval.
If final authorisation does not reach the hospital within 4 hours after mail or portal submission, the patient must pay the hospital bill in full and claim reimbursement.
If TPA rejects or delays authorisation within 2-3 days of admission, the patient must settle the bill and may apply for reimbursement.
If final approval is not received, the patient must pay the final bill.

Policy section

Sunday, holiday, and system-failure situations

There is no cashless processing on Sundays, public holidays, or hospital holidays.
If phone, internet, portal, or other communication systems fail, patients may need to make full payment and claim reimbursement.
In a death case on Sunday or holiday, cashless processing will be done only on the next working day.

Policy section

Security deposit, deductions, and package differences

A non-interest-bearing security deposit of 15% of the final approved amount is collected at discharge. If the stay is more than 21 days, the deposit is 20%.
Non-medical items, administrative deductions, admission charges, pharmacy deductions, co-payment, and exclusions must be paid by the patient.
If treatment, diagnosis, room class, package, or sanctioned limit changes, any unapproved difference must be paid by the patient.
Emergency surgeries and surgeries performed between 6:00 PM and 8:00 AM on Sundays, public holidays, or hospital holidays attract 25% extra charges.
Patients should understand policy terms, sum insured, co-payment, inclusions, and exclusions from the agent, TPA, or insurance company.

Policy section

Outside investigations and special billing situations

The pre-authorisation form will contain actual treatment facts. Requests to change facts will not be accepted.
MRI and some pathology tests may be done outside the hospital and may require patient-first payment.
In LAMA discharge, cashless service is not applicable and the bill must be paid in full.
If the patient is transferred to another hospital, the bill must be paid in full.