P.D. Hinduja Hospital, Khar also provides cashless benefits to insured patients and corporations along with Third Party Administrators (TPAs). The Front Office Personnel are trained to expedite the Admission Process, so that your visit to the hospital is comfortable.
Cashless hospitalization means as a policyholder, one will be able to avail medical services at designated hospitals and bills will be settled through TPAs (Third Party Administrators) rather than direct out-of-pocket-payment.
In case of a planned admission, you would have first consulted a doctor who in turn would have advised you on the probable date of hospitalization. In such a case, you must apply for approval of the estimated hospital expenses directly by your TPA at least 4-5 days prior to the date of hospitalization.
In case you have not applied for pre-authorization sufficiently in advance or if the doctor treating you advises you to get hospitalized immediately after the consultation, our TPA / Corporate Help Desk (Phone: 022-61746035) will assist you through the pre-authorization procedure. Normal working hours are from 9.00 a.m. to 7.00 p.m., Monday to Saturday, except public holidays.
However, the Corporate Help Desk is only a facilitator and can in no way influence the decision on the approval. Your TPA may not grant approval due to any of the following reasons:
Step 1: Establish contact with the TPA / Corporate Help Desk at the hospital.
Step 2: At the TPA / Corporate Help Desk, you need to present the original Health Insurance card issued to you by your TPA.
Step 3: Collect the pre-authorization forms pertaining to your TPA.
Step 4: Your pre-authorization form will have two sections-
Step 5: Return the completed form to the TPA / Corporate Help Desk along with the copies of the document mentioned in the TPA checklist. The personnel at the desk will verify the form for its completeness and let you know in case of any discrepancy.
Step 6: Once the form is complete in all respects, the TPA / Corporate Help Desk will upload the documents on the remedient portal and transmit to the office of your TPA.
Step 7: The TPA/ Corporate Help Desk will revert to you on the approval/denial status. Also, status of approval is updated on registered mobile no.
Step 8: At the time of admission, you shall be required to pay differential amount of admission deposit and TPA approval. The differential amount would be refunded on discharge after receiving the final approval as per the final bill. A TPA deposit payment of Rs.10,000/- has to be paid on admission, which shall be refunded post discharge, subject to completion of all formalities and payment received by the hospital.
What if the cost for treatment exceeds the approved sum?
In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. The TPA / Corporate Help Desk will take up your case on a fast track basis with your TPA and is likely to receive approvals within 6 hours during any working day.
Step 1: Show your health insurance card and fill in the pre-authorization form.
Step 2: The Corporate /TPA desk in the hospital will fast track the process for your cashless process but in case you cannot wait for the approval, you can pay the deposit demanded by the hospital and start the treatment and reimburse the expense later on.
Step 3: Generally, the time taken to process an emergency case is 6 hours, but will depend upon the insurance co / TPA. You need to follow up with the TPA to know the status of the request.
Below is the list of Insurance Company and TPAs empanelled with us to create a secure healthcare experience: