Insurance and TPA

To guide through the cashless service procedure for Health Insurance Policy holders, IQ City Medical College Hospital has a specialized Insurance desk located at the foyer.

Guidelines for Cashless Hospitalization is as Detailed Below:

In Cashless health insurance Service, when you get hospitalized with a network hospital, you do not have to settle the bill with the hospital. The Insurance Company represented by the TPA, co-ordinates with the hospital and settles the bill. You will be required to pay Non admissible items and other charges as per terms and condition of the policy.

In case of Denial from TPA entire Bill amount is to be paid and submit the claims for possible reimbursement.

Essential Documentation Required For Cashless Services:

ID card issued from TPA/Insurance Company
Photocopy of ID card issued from Govt. body (Pan Card, Voters ID Card, Passport etc.)
Current year Policy Copy
In case of Corporate Insurance policy, ID card issued from employer.

Process For Cashless Facility

Planned Hospitalization:

In a planned hospitalization, you have a recommendation for hospitalization by your doctor before admission, hence, it is recommended to take cashless approval at least 3-4 days before admission.
It is requested to contact the TPA Desk with all requisite documents. Our executive will help and guide you through the cashless procedures.

Emergency Hospitalization:

In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. You need to start the procedure for cashless mediclaim facility within 24 hours of hospitalization.
Hence, it is requested to submit the Insurance documents as early as possible after admission.

What is not Paid?

You may notice that even with the cashless service, there are some expenses that you will have to bear, these expenses are:

Registration or admission fee
Visitors/ Attendant’s fee
Charges for diet
Ambulance charges
Toiletries
Document charges
Service charge
Non admissible items

Why is the Request for Cashless Rejected?

If the ailment for which you are hospitalized is not covered in your policy.
If you have exhausted the sum assured for that year.

Discharge Process Time

Generally the TPA initially approves a part of the hospitalization expenses; Final authorization amount is approved only after submission final bill along with the discharge summary and other reports.
This patient relative has to wait till authorization is received from TPA, post discharge of the patient.

Service Guidelines

Cashless service is available through empanelled TPA/Insurance Co only.
All the medical documents including the lab reports, claim forms, discharge summary and final bill has to be submitted to the hospital before being discharged.
If the TPA does not approve your request, you can pay the bill now and reimburse it later.
Cashless facility is subject to the conditions and terms in the policy.
Please go through the policy paper to understand the terms and condition of the policy.