ATREUM SPECIALITY HOSPITAL group provides comfortable and hassle-free hospitalization services as it has got associated with some of the reputed and leading health insurance companies. You can also avail cashless hospitalization based on your insurance service provider.
List of Insurance companies, TPA’s and Corporate Health Services
Aditya Birla Health Ins. Co. Ltd
Aegon Life Ins. Co. Ltd
Apollo Munich Health Ins. Co. Ltd
Bharathi AXA General Insurance
Cholamandalam General Ins Co. Ltd
DHFL General Insurance Ltd
Edelweiss General Ins. Co. Ltd
E-Meditek Insurance TPA Ltd
Family Health Plan Ltd (FHPL)
Future General India Ins Co. Ltd
Genins India TPA Ltd
Go Digit General Ins. Ltd
HDFC Ergo General Ins. Co. Ltd
HDFC Life Ins. Co.
Religare Health Ins. Co. Ltd
Royal Sundaram Gen Ins. Co. Ltd
SBI General Ins. Co.
Star Health & Allied Insurance Company Ltd
IFFCO Tokio General Ins. Co. Ltd
Kotak Mahindra General Ins. Co. Ltd
L & T General Insurance Ltd
Liberty General Insurance Co.
MAGMA HDI General Ins. Co. Ltd
Manipal CIGNA Health Ins. Co. Ltd
Max Life Ins. Co.
Medi Assist Insurance TPA Pvt Ltd
Medsave Health TPA Ltd
Paramount Health Services TPA Pvt Ltd
PSU- National Insurance Company
PSU- New India Assurance Company
PSU- Oriental Insurance Company
Raheja QBE General Ins. Co. Ltd
Raksha Health Insurance TPA Pvt Ltd
Reliance General Ins. Co. Ltd
TATA AIG Gen. Ins. Co. Ltd
Universal Sompo Gen. Ins. Co. Ltd
Vidal Health Insurance TPA Services
Vipul Med Corp TPA Pvt Ltd
PROCESS OF INSURANCE (CASHLESS CLAIMS) AT ATREUM HOSPITAL
To check the availability for cashless facility by speaking to our staff.
Policy holder shall produce copies of his/her ID card provided by TPA along with photo ID card for address proof (Driving License/Adhaar Card/Voters ID/Passport – any one) and Policy Certificate.
The ID card should have photograph and signature or thumb impression of the patient.
The beneficiaries (patient) will be identified by the provider (hospital) on the basis of a photo ID card issued by Insurance Company.
Insurance Help Desk staff will verify following details with the help of ID card & policy certificate copy
Patients name and spelling
Card validity (From and To)
The following Terms & Conditions shall be explained to the patient for availing cashless facility.
When a doctor plans for admission, the in-house insurance staff will verify the ID Card , Photo ID, Policy Certificate copy and get the concerned pre-authorization form filled up and signed with the seal of the doctor. The Patient/attendant has to sign and enter the contact number in the pre-auth form. The same is sent to TPA / Insurance Company along with relevant investigations reports in case of planned admission. This can be done up to 7 days prior to expected date of admission
In case of emergency admission, duly filled-in pre-authorization form would be sent within 24 hours of admission. Any delay will be communicated with TPA by insurance staff.
The Pre authorization approval issued by the insurance company will have the following details like amount guaranteed, sub limits for room category, surgical fees, eligibility of beneficiary, validity of the approval letter as per the benefit plan of the insured.
The guarantee of payment is given only for the necessary treatment cost of the ailment covered and mentioned in the request for hospitalization.
Any investigation or treatment carried out at the request of the patient apart from the authorization, such of those treatment charges will have to be borne by the patient only.
When the cost of treatment exceeds the authorized limit an interim bill along with justification letter from treating doctor is sent for further enhancement of approval amount. At the time of discharge final approval should be obtained by sending the final bill, break up of charges, discharge summary, pharmacy bills and any other information as required by TPA.
Patient discharge will be taken up on receipt of final approval.
The final approval will have the eligible amount and remarks on exclusions like non-medical expenses, co-payment and other disallowances, the cost of which shall be borne by the patient. Hence, after collecting the difference of amount the patient would be discharged.
If the enhancement amount does not get cleared by Insurance Company, the balance amount shall be paid by patient/attendant.
If the total claim amount gets denied by Insurance Company (TPA), then the patient/attendant has to clear the bills generated as per the hospital’s norms.